Ghallab Muhammad, Abosheaishaa Hazem, Gupta Ishank, Abdelmoteleb Salma, Stern Roger
Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, USA.
Internal Medicine/Gastroenterology, Cairo University, Cairo, EGY.
Cureus. 2022 Dec 12;14(12):e32447. doi: 10.7759/cureus.32447. eCollection 2022 Dec.
Carbohydrate antigen 19-9 (CA 19-9) is a tumor marker used clinically to support the diagnosis and recurrence of pancreatic adenocarcinoma. CA 19-9 levels may be found to be elevated too in benign conditions, including hepatobiliary diseases such as choledocholithiasis, cholangitis, or cholestasis of any etiology. In this case, we are presenting a case of a 66-year-old man who has presented with diffuse abdominal pain and has been then found to have choledocholithiasis and obstructive jaundice treated with biliary sphincterotomy and balloon extraction. In the setting of extensive unclear gastroenterological surgeries, tumor markers were obtained, and the results revealed markedly elevated CA 19-9 with negative other tumor markers and a negative workup for malignancy. After reviewing the literature, we found that although CA 19-9 has been studied in diagnosing pancreatic and biliary malignancies, the serum level may also be elevated in many other benign conditions. As a result, the results must be individualized according to the clinical scenario of each patient.
糖类抗原19-9（CA 19-9）是一种临床上用于辅助诊断胰腺腺癌及判断其复发情况的肿瘤标志物。在一些良性疾病中，包括如胆总管结石、胆管炎或任何病因引起的胆汁淤积等肝胆疾病，也可能发现CA 19-9水平升高。在此，我们报告一例66岁男性患者，该患者因弥漫性腹痛就诊，随后被诊断为胆总管结石并伴有梗阻性黄疸，接受了胆管括约肌切开术和球囊取石治疗。在进行了广泛的不明原因的胃肠外科手术后，检测了肿瘤标志物，结果显示CA 19-9显著升高，其他肿瘤标志物为阴性，恶性肿瘤检查结果为阴性。查阅文献后，我们发现尽管CA 19-9已被用于诊断胰腺和胆道恶性肿瘤，但在许多其他良性疾病中血清水平也可能升高。因此，必须根据每位患者的临床情况对结果进行个体化分析。
