Elevated Ca 19-9 Levels in Patient With Cholecystitis

Abstract

Although CA 19-9 is a tumour marker, high levels of CA 19-9 have also been reported in benign conditions such as acute cholangitis or pancreatitis. We present here a 56-year-old woman with complicated cholecystitis due to gallstone and elevated serum CA19-9 levels. After cholecystectomy procedure CA19-9 level returned to normal. The level of CA 19-9 should never be regarded as a gold standard but rather as a helpful indicator when searching pancreatic and biliary malignancies. ©2007, Firat University, Medical Faculty

Keywords

• -

Kolesistitli Bir Olguda Yüksek Ca 19-9 Seviyesi

Öz

CA 19-9 bir tumör belirleyicisi olarak kullanılmasına rağmen akut kolanjit ve pankreatit gibi benign durumlarda da yüksek düzeyleri bildirilmiştir. Bu vakada 59 yaşında safra taşına bağlı komplike olmuş bir kolesistit ile birlikte yükselmiş CA 19-9 düzeyine sahip bir hastamızı sunuyoruz. CA 19-9 düzeyi kolesistektomi sonrasında normale döndü. CA 19-9 düzeyi altın standart bir test olmamakla birlikte, pankreas ve safra kesesi malignitelerini araştırmada yardımcı bir test olarak kabul edilmelidir. ©2007, Fırat Üniversitesi, Tıp Fakültesi

Anahtar Kelimeler

• CA 19-9, kolesistit, benign hastalık

Kaynakça

1. Minato H, Nakanuma Y, Teroda Y. Expression of blood group- related antigens in cholangiocarcinoma in relation to non- neoplastic bile ducts. Histopathology 1996; 28: 411-419.
2. Akdogan M, Sasmaz N, Kayhan B, et al. Extraordinarily elevated CA19-9 in benign conditions: a case report and review of the literature. Tumori 2001; 87: 337-339.
3. Maestranzi S, Premioslo R, Mitchell H, et al. The effect of benign and malignant liver disease on the tumor markers CA 19-9 and CEA. Ann Clin Biochem 1998; 35: 99-103.
4. Jalanka H, Kuusela P, Roberts P, et al. Comparison of a new tumor marker, CA 19-9, with alpha fetoprotein and carcinoembryonic antigen in patients with upper gastrointestinal diseaes. J Clin Pathol 1984; 37: 218-222.
5. Andriulli A, Gindro T, Piantino P, et al. Prospective evaluation of the diagnostic efficacy of CA 19-9 assay as a marker for gastrointestinal cancers. Digestion 1986; 33: 26-33.
6. Steinberg W. The clinical utility of the CA 19-9 tumor-associated antigen. Am J Gastroenterol 1990; 85: 350-355.
7. Albert MB, Steinberg WM, Henry JP. Elevated serum levels of tumor marker CA 19-9 in acute cholangitis. Dig Dis Sci 1988; 33: 1223-1225.
8. Milionis HJ, Elisaf MS, Tsianos EV. Post-cholecystectomy transient hundred-fold increase in CA 19-9. Eur J Gastroenterol Hepatol 1997; 9: 1013-1014.

9. Katsonos HK, Kitsanou M, Christodoulou DK, et al. High CA 19-9 levels in benign biliary tract diseases Report of four cases and review of the literature. Eur J Intern Med 2002; 13: 132-135.
10. Kim HJ, Kim MH, Myung SJ, et al. A new strategy for the application of CA19-9 in the differentiation of pancreaticobiliary cancer: analysis using a receiver operating characteristic curve. Am J Gastroenterol 1999; 94: 1941-1946.
11. Lin CL, Changchien CS, Chen YS. Mirizzi’s syndrome with a high CA 19-9 level mimicking cholangiocarcinoma. Am J Gastroenterol 1997; 92: 2309-2310.
12. Ker CG, Chen JS, Lee KT, et al. Assessment of serum and bile levels of CA 19-9 and CA 125 in cholangitis and bile duct carcinoma. J Gastroenterol Hepatol 1991; 6: 505-508.
13. Kabul Tarihi: 04.07.2006