CA 19-9
Updates to Article Attributes
CA 19-9 (carbohydrate antigen 19-9 or cancer antigen 19-9) is a serum antigen (monosialoganglioside) that has increased diagnostic use in the management of several malignancies, mainly of hepatopancreaticobiliary origin. It is non-specific, however, and can rise in both malignant and non-malignant conditions.
Elevated serum CA 19-9
Elevation of serum CA 19-9 has been associated with many conditions including the following:
-
hepatopancreaticobiliary malignancies
-
a CA 19-9 of >100 U/mL may have a sensitivity of 50% in diagnosing cholangiocarcinoma 3
when it is elevated with proven malignancy, larger unresectable tumours are generally thought to have higher levels of elevation
-
with an upper limit of normal at 37 U/mL, the assays overall sensitivity is approximately 80% and its specificity is 90% for pancreatic adenocarcinoma 1
when it is elevated with proven malignancy, larger unresectable tumours are generally thought to have higher levels of elevation 5
-
-
other malignancies
-
non-malignant hepatopancreaticobiliary conditions 4: the increase is generally small
chronic and alcoholic hepatitis
acute hepatic necrosis
non-malignant obstructive jaundice: usually should go down after relief of obstruction unless there is an associated malignancy 7
-
non-hepatopancreaticobiliary conditions:
-
others
heavy tea consumption 6
History and etymology
It was initially discovered byH Koprowski and co-workers in 1980 associated with colon and pancreatic cancer 9.
-<li>hepatopancreaticobiliary malignancies<ul>-<a href="/articles/cholangiocarcinoma">cholangiocarcinoma</a><ul>-<li>a CA 19-9 of >100 U/mL may have a sensitivity of 50% in diagnosing cholangiocarcinoma <sup>3</sup>-</li>-<li>when it is elevated with proven malignancy, larger unresectable tumours are generally thought to have higher levels of elevation </li>- +<p>hepatopancreaticobiliary malignancies</p>
- +<ul>
- +<li>
- +<p><a href="/articles/cholangiocarcinoma">cholangiocarcinoma</a></p>
- +<ul>
- +<li><p>a CA 19-9 of >100 U/mL may have a sensitivity of 50% in diagnosing cholangiocarcinoma <sup>3</sup></p></li>
- +<li><p>when it is elevated with proven malignancy, larger unresectable tumours are generally thought to have higher levels of elevation </p></li>
-<a href="/articles/pancreatic-ductal-adenocarcinoma-2">pancreatic adenocarcinoma</a><ul>-<li>with an upper limit of normal at 37 U/mL, the assays overall sensitivity is approximately 80% and its specificity is 90% for pancreatic adenocarcinoma <sup>1</sup>-</li>-<li>when it is elevated with proven malignancy, larger unresectable tumours are generally thought to have higher levels of elevation <sup>5</sup>-</li>- +<p><a href="/articles/pancreatic-ductal-adenocarcinoma-4">pancreatic adenocarcinoma</a></p>
- +<ul>
- +<li><p>with an upper limit of normal at 37 U/mL, the assays overall sensitivity is approximately 80% and its specificity is 90% for pancreatic adenocarcinoma <sup>1</sup></p></li>
- +<li><p>when it is elevated with proven malignancy, larger unresectable tumours are generally thought to have higher levels of elevation <sup>5</sup></p></li>
-<li>other malignancies<ul>-<li><a href="/articles/colorectal-cancer-1">colorectal carcinoma</a></li>-<li>-<a href="/articles/gastric-adenocarcinoma">gastric carcinoma</a> <sup>12</sup>-</li>-<li>-<a title="Lung cancer" href="/articles/lung-cancer-3">lung cancer</a> <sup>11</sup>-</li>-<li>-<a href="/articles/hepatocellular-carcinoma">hepatocellular carcinoma (HCC)</a> <sup>11</sup>-</li>-<li>-<a href="/articles/ovarian-tumours">ovarian carcinoma</a> <sup>11</sup>-</li>-<a title="Gallbladder cancer" href="/articles/gallbladder-cancer-2">gallbladder cancer</a> <sup>14</sup>-</li>- +<p>other malignancies</p>
- +<ul>
- +<li><p><a href="/articles/colorectal-cancer-1">colorectal carcinoma</a></p></li>
- +<li><p><a href="/articles/gastric-adenocarcinoma">gastric carcinoma</a> <sup>12</sup></p></li>
- +<li><p><a href="/articles/lung-cancer-3" title="Lung cancer">lung cancer</a> <sup>11</sup></p></li>
- +<li><p><a href="/articles/hepatocellular-carcinoma">hepatocellular carcinoma (HCC)</a> <sup>11</sup></p></li>
- +<li><p><a href="/articles/ovarian-tumours">ovarian carcinoma</a> <sup>11</sup></p></li>
- +<li><p><a href="/articles/gallbladder-cancer-2" title="Gallbladder cancer">gallbladder cancer</a> <sup>14</sup></p></li>
-<li>non-malignant hepatopancreaticobiliary conditions <sup>4</sup>: the increase is generally small<ul>-<a href="/articles/acute-pancreatitis">acute </a>and <a href="/articles/chronic-pancreatitis-2">chronic pancreatitis</a>-</li>- +<p>non-malignant hepatopancreaticobiliary conditions <sup>4</sup>: the increase is generally small</p>
- +<ul>
- +<li><p><a href="/articles/acute-pancreatitis">acute </a>and <a href="/articles/chronic-pancreatitis-2">chronic pancreatitis</a></p></li>
-<a href="/articles/cholecystitis">cholecystitis</a><ul><li>-<a title="Xanthogranulomatous cholecystitis" href="/articles/xanthogranulomatous-cholecystitis">xanthogranulomatous cholecystitis</a> (levels may be very elevated) <sup>13</sup>-</li></ul>-</li>-<li><a href="/articles/cirrhosis">cirrhosis</a></li>-<li>chronic and alcoholic hepatitis</li>-<li>acute hepatic necrosis</li>-<li><a href="/articles/gallstones-1">gallstones</a></li>-<li>non-malignant <a href="/articles/jaundice">obstructive jaundice</a>: usually should go down after relief of obstruction unless there is an associated malignancy<sup> 7 </sup>- +<p><a href="/articles/cholecystitis">cholecystitis</a></p>
- +<ul><li><p><a href="/articles/xanthogranulomatous-cholecystitis" title="Xanthogranulomatous cholecystitis">xanthogranulomatous cholecystitis</a> (levels may be very elevated) <sup>13</sup></p></li></ul>
- +<li><p><a href="/articles/cirrhosis">cirrhosis</a></p></li>
- +<li><p>chronic and alcoholic hepatitis</p></li>
- +<li><p>acute hepatic necrosis</p></li>
- +<li><p><a href="/articles/gallstones-1">gallstones</a></p></li>
- +<li><p>non-malignant <a href="/articles/jaundice">obstructive jaundice</a>: usually should go down after relief of obstruction unless there is an associated malignancy<sup> 7</sup></p></li>
-<li>non-hepatopancreaticobiliary conditions:<ul>-<li>lung disorders (<a href="/articles/cystic-fibrosis">cystic fibrosis</a>, <a href="/articles/pneumonia">pneumonia</a>, <a href="/articles/tuberculosis">tuberculosis</a>, <a href="/articles/pleural-effusion">pleural effusion</a>)</li>-<li><a href="/articles/pelvic-inflammatory-disease">pelvic inflammatory disease</a></li>-<li><a href="/articles/hashimoto-thyroiditis">Hashimoto thyroiditis</a></li>-<li><a href="/articles/rheumatoid-arthritis">rheumatoid arthritis</a></li>-<li><a href="/articles/chronic-kidney-disease">renal failure</a></li>-<li><a href="/articles/systemic-lupus-erythematosus">systemic lupus erythematosus (SLE)</a></li>- +<li>
- +<p>non-hepatopancreaticobiliary conditions:</p>
- +<ul>
- +<li><p>lung disorders (<a href="/articles/cystic-fibrosis">cystic fibrosis</a>, <a href="/articles/pneumonia">pneumonia</a>, <a href="/articles/tuberculosis">tuberculosis</a>, <a href="/articles/pleural-effusion">pleural effusion</a>)</p></li>
- +<li><p><a href="/articles/pelvic-inflammatory-disease">pelvic inflammatory disease</a></p></li>
- +<li><p><a href="/articles/hashimoto-thyroiditis">Hashimoto thyroiditis</a></p></li>
- +<li><p><a href="/articles/rheumatoid-arthritis">rheumatoid arthritis</a></p></li>
- +<li><p><a href="/articles/chronic-kidney-disease">renal failure</a></p></li>
- +<li><p><a href="/articles/systemic-lupus-erythematosus">systemic lupus erythematosus (SLE)</a></p></li>
-<li>others<ul>-<li>heavy tea consumption<sup> 6</sup>-</li>-<a href="/articles/idiopathic">idiopathic</a> <sup>4</sup>-</li>- +<p>others</p>
- +<ul>
- +<li><p>heavy tea consumption<sup> 6</sup></p></li>
- +<li><p><a href="/articles/idiopathic">idiopathic</a> <sup>4</sup></p></li>
-</ul><h4>History and etymology</h4><p>It was initially discovered by<strong> H Koprowski</strong> and co-workers in 1980 associated with colon and pancreatic cancer <sup>9</sup>.</p>- +</ul><h4>History and etymology</h4><p>It was initially discovered by<strong> </strong>H Koprowski and co-workers in 1980 associated with colon and pancreatic cancer <sup>9</sup>.</p>
References changed:
- 14. Sachan A, Saluja S, Nekarakanti P et al. Raised CA19-9 and CEA Have Prognostic Relevance in Gallbladder Carcinoma. BMC Cancer. 2020;20(1):826. <a href="https://doi.org/10.1186/s12885-020-07334-x">doi:10.1186/s12885-020-07334-x</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/32867709">Pubmed</a>
- 14. Sachan A, Saluja S, Nekarakanti P et al. Raised CA19–9 and CEA Have Prognostic Relevance in Gallbladder Carcinoma. BMC Cancer. 2020;20(1):826. <a href="https://doi.org/10.1186/s12885-020-07334-x">doi:10.1186/s12885-020-07334-x</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/32867709">Pubmed</a>