Han Ping, Yan Wei, Luo Yi, Tu Wei, He Jia-Yi, Liu Jing-Mei, Gong Jin, Wang Yun-Wu, Li Meng-Ke, Tian De-An, Huang Huan-Jun
Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, China.
Tuberculosis Prevention Institution of Wuhan Wuhan 430030, China.
Int J Clin Exp Pathol. 2014 Aug 15;7(9):6307-12. eCollection 2014.
Carbohydrate antigen 19-9 (CA19-9) is the most frequently applied serum tumor marker for diagnosis of cancers in the digestive organs. However, some patients with benign diseases can have elevated serum levels of CA19-9 as well. The current study presents a 55-year-old female who was admitted to our hospital for further evaluation of a nodular cavity shadow in the right lower lobe and clarification of the cause of the marked elevation of serum CA19-9 levels. Abdominal MRI and gastrointestinal endoscopy did not find any malignancy. As lung cancer cannot be excluded in this patient, a video-assisted thoracoscopic surgery was carried, intraoperative and postoperative biopsy analysis both suggested chronic bronchitis with fungal infection (due to Histoplasma capsulatum or Penicillium marneffei) and organization. Immunohistochemistry showed marked positive staining for CA19-9 in the damaged lung tissue. The CA19-9 levels quickly returned to the normal range following lobe resection. Therefore, the marked elevation of serum CA19-9 levels, in this case, may have resulted from the chronic bronchitis with fungal infection.
糖类抗原19-9（CA19-9）是消化系统癌症诊断中最常用的血清肿瘤标志物。然而，一些患有良性疾病的患者血清CA19-9水平也可能升高。本研究报告了一名55岁女性，因右下叶结节状空洞阴影需进一步评估以及血清CA19-9水平显著升高的原因待明确而入住我院。腹部MRI和胃肠内镜检查未发现任何恶性病变。由于不能排除该患者患有肺癌，遂进行了电视辅助胸腔镜手术，术中及术后活检分析均提示慢性支气管炎伴真菌感染（由荚膜组织胞浆菌或马尔尼菲青霉菌引起）及机化。免疫组化显示受损肺组织中CA19-9呈明显阳性染色。肺叶切除术后CA19-9水平迅速恢复至正常范围。因此，在这种情况下，血清CA19-9水平的显著升高可能是由慢性支气管炎伴真菌感染所致。
