Pall Mahander, Iqbal Javid, Singh Shrawan Kumar, Rana Satya Vati
Department of General Surgery, PGIMER, Chandigarh, India.
Urol Ann. 2012 May;4(2):98-101. doi: 10.4103/0974-7796.95555.
CA 19-9 is a carbohydrate antigen related to Lewis A blood group antigen. It is well-known marker for pancreatic carcinoma and is being investigated for other malignancies including carcinoma bladder. We evaluated the role of serum CA 19-9 as a tumor marker and correlated its level with tumor stage and grade.
Seventy-five patients with histologically proven urothelial carcinoma were included in this study as case and 25 healthy volunteers as control. Preoperative 5 ml blood sample was collected. Serum level of CA 19-9 was measured using solid-phase enzyme-linked immunosorbent assay kit. The value of CA19-9 was expressed in U/ml and 37 U/ml was taken as cut-off upper value of normal.
The range of CA19-9 in patients of urothelial carcinoma was 2 to 122 U/ml with a mean of 26.33±29.28, while in control, it was 8.48±5.01 U/ml (P<0.001). The sensitivity of CA19-9 was 29%. Serum CA19-9 was significantly elevated in invasive disease in comparison with superficial disease (47.17±34.43 vs 16.53±20.13) (P<0.001). Significantly high proportion of patients with invasive disease had value ≥37 U/ml (14/24 [58.3%] vs 8/51 [15.7%]) with P value <0.001. High proportion of high-grade tumor had raised value, 14/34 (41.25%); all patients with metastatic disease had value more than 37 U/ml.
Serum CA19-9 is a marker of aggressiveness of urothelial carcinoma and is almost invariably raised in patients with metastatic disease. Thus, it may be used as a prognostic marker but not as a screening tool due to its low sensitivity.
CA 19-9是一种与Lewis A血型抗原相关的碳水化合物抗原。它是胰腺癌的知名标志物，目前正在针对包括膀胱癌在内的其他恶性肿瘤进行研究。我们评估了血清CA 19-9作为肿瘤标志物的作用，并将其水平与肿瘤分期和分级相关联。
本研究纳入75例经组织学证实的尿路上皮癌患者作为病例组，25名健康志愿者作为对照组。术前采集5ml血液样本。使用固相酶联免疫吸附测定试剂盒测定血清CA 19-9水平。CA19-9的值以U/ml表示，37 U/ml被视为正常上限临界值。
尿路上皮癌患者的CA19-9范围为2至122 U/ml，平均为26.33±29.28，而对照组为8.48±5.01 U/ml（P<0.001）。CA19-9的敏感性为29%。与浅表疾病相比，侵袭性疾病患者的血清CA19-9显著升高（47.17±34.43对16.53±20.13）（P<0.001）。侵袭性疾病患者中CA值≥37 U/ml的比例显著更高（14/24 [58.3%]对8/51 [15.7%]），P值<0.001。高分级肿瘤患者中CA值升高的比例较高，为14/34（41.25%）；所有转移性疾病患者的CA值均超过37 U/ml。
血清CA19-9是尿路上皮癌侵袭性的标志物，转移性疾病患者几乎无一例外升高。因此，由于其低敏感性，它可作为预后标志物，但不能作为筛查工具。
