Causes of Elevated Levels of Serum CA 19.9 in Patients without Prior Diagnosis of Malignant Disease

Abstract

INTRODUCTION[|]Serum CA 19.9 is commonly used as a tumor marker for diagnosis and follow-up of gastrointestinal malignancies. However, elevated levels can be found in various clinical conditions.[¤]METHODS[|]A total of 285 patients whose serum CA 19.9 level was ordered from various outpatient clinics other than oncology in a tertiary hospital setting and who had elevated CA 19.9 (>34 U/mL) levels were included in the study group. Statistical analysis of marker levels in relation to diagnosis of patients was performed.[¤]RESULTS[|]Overall, 226 patients with benign disorders and 59 patients with malignant disease had elevated CA 19-9 levels. One hundred ten (39%) patients with increased CA 19-9 levels did not have any significant clinical condition associated with high CA 19-9 values. Median CA 19-9 levels were significantly higher in patients with malignancies than in patients with benign disorders (67.3 vs. 47.9; p<0.001). Receiver operating characteristic curve analysis identified a cut-off value of 66.3 U/mL for discrimination of malignant from benign gastrointestinal diseases (sensitivity 58.3% and specificity 82.7%; p<0.001).[¤]DISCUSSION AND CONCLUSION[|]Serum CA 19-9 levels are significantly higher in patients with malignant diseases. However, there are diverse etiologies associated with elevated serum levels. During chronic inflammatory states, elevated serum CA 19-9 levels can be a frequent finding.[¤]

Keywords

• ca 19-9
• inflammation; malignancy.