Comparison of a new tumour marker, CA 19-9, with alpha-fetoprotein and carcinoembryonic antigen in patients with upper gastrointestinal diseases.

TLDR

Serum CA 19‑9 levels were measured in 246 patients with benign and malignant gastrointestinal diseases. CA 19‑9 was elevated in 76 % of pancreatic, 73 % of cholangiocarcinoma, 42 % of gastric, and 22 % of hepatoma cases, was mainly high in metastatic cancers, normal in most localized carcinomas and all benign gastric disease, and while not entirely specific, it outperformed AFP for hepatomas and CEA for distinguishing malignant from benign gastrointestinal disease.

Abstract

Serum CA 19-9 antigen concentrations were measured in 246 patients with benign and histologically confirmed malignant gastrointestinal diseases. The CA 19-9 concentration was above the upper limit of the normal range (0-37 U/ml) in 76% of patients with pancreatic carcinoma, 73% of patients with cholangiocarcinoma, 42% of patients with gastric carcinoma, and 22% of patients with hepatoma. High CA 19-9 concentrations were found mainly in patients with a metastasised cancer, whereas 71% of patients with a localised carcinoma had normal CA 19-9 concentrations. All of the patients with benign gastric diseases had normal CA 19-9 values. Moderately increased concentrations were found in 15-36% of the patients with benign pancreatic, liver, and biliary tract diseases. alpha-fetoprotein was a better marker for hepatomas than CA 19-9. CA 19-9 was better than carcinoembryonic antigen in differentiating malignant from benign diseases. The results indicate that the CA 19-9 assay is not completely specific for cancer but serves as a valuable adjunct, especially in the diagnosis of pancreatic carcinoma.