The High Prevalence of Short-Term Elevation of Tumor Markers Due to Hyperglycemia in Diabetic Patients

Abstract

The relationship between diabetes and cancer is uncertain. However, tumor markers in diabetic patients are significantly elevated. The prevalence of diabetic inpatients with elevation of tumor markers and its relationship to blood glucose is needed to be studied. Methods: A total of 102 diabetic inpatients were included in this study. We collected information from diabetic inpatients and tested tumor markers. Patients with elevation of tumor markers were rechecked. Results: We found that up to 73.3% of diabetic inpatients had one or more tumor markers elevated. The proportion of diabetic inpatients with higher than normal cytokeratin 19 fragment (CYFRA 21-1) was 54.5%. Most of them did not return to normal after controlling the blood glucose. A short-term elevation of carcinoembryonic antigen (CEA) was present in 15.8% of diabetic inpatients, and 19.8% of diabetic inpatients had a short-term elevation of carbohydrate antigen. CEA and carbohydrate antigen including CA19-9, CA72-4, CA125 and CA15-3 returned to normal or became significantly reduced within 2 weeks after good control of blood glucose. Conclusion:Our study showed that the elevation of tumor markers was common in diabetic inpatients, especially those with poor blood glucose control. It indicated that re-checking the tumor markers after controlling blood glucose might be better than conducting large-scale test for cancer.

Association of Circulating Carbohydrate Antigen 19-9 Level with Type 2 Diabetic Kidney Disease in Chinese Adults: A Cross-Sectional Study

“…Studies found that persistent hyperglycemia, excessive cholesterol accumulation, and hypertension might contribute to glucolipotoxicity and inflammation and oxidative stress in the islet β cells, subsequently leading to pancreatic β cell dysfunction and impaired insulin secretion, eventually triggering the release of CA19-9, which was a marker of pancreatic exocrine tissue damage, through the pancreatic ducts. 8 , 13 , 32 , 34–36 , 38 , 39 These data together suggest that circulating CA19-9 level might be associated with DKD in T2DM patients due to pancreatic β cell dysfunction and impaired insulin secretion induced by poor metabolic control. Future research is required to confirm our findings and to better understand the mechanisms associated with a possible pathogenic effect of circulating CA19-9 on DKD.…”

High Prevalence of Abnormal Carcinoembryonic Antigen in Diabetic Inpatients with Poor Glycemic Control

“…In previous studies, we found CEA returned to normal or became significantly reduced within 2 weeks after good glycemic control. 10 Therefore, our study can remind clinicians that when the CEA level is above normal in diabetic patients, especially for those with HbA1c ≥ 9%, it may be related to poor glycemic control, and the CEA level can become normal or significantly reduced after good control of blood glucose, avoiding unnecessary panic and unnecessary tests about cancer.…”

“…[7][8][9] We found that there was a short-term elevation of CEA in diabetic inpatients, and there was a significant difference in HbA1c between the elevated CEA group and the group with normal CEA. 10 However, due to the insufficient number of patients, correlation analysis was not conducted in our last study. In this study, we expanded the sample size and performed correlation analysis to explore whether the CEA increase in diabetic inpatients was related to age, gender, blood pressure, lipid or other factors.…”

Factors influencing blood tumor marker concentrations in the absence of neoplasia

“…Patients with poorly controlled diabetes (HbA1 C>8%) had a higher proportion of false positives than their peers with well-controlled diabetes. However, the values in the poorly controlled patients returned to normal levels when glycemic control was restored [127].…”