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[CA19-9 has no value as a tumor marker in obstructive jaundice]
R Peterli1, B Meyer-Wyss, U Herzog
1Allgemeinchirurgische Abteilung, St. Claraspital, Basel.
Schweizerische Medizinische Wochenschrift
|March 5, 1999
Summary
Very high CA19-9 levels can indicate benign obstructive jaundice, not just pancreatic cancer. Successful treatment of biliary obstruction is crucial for accurate diagnosis.
Area of Science:
- Gastroenterology and Hepatology
- Oncology
- Clinical Chemistry
Background:
- Carbohydrate antigen 19-9 (CA19-9) is a widely used tumor marker for pancreatic cancer.
- Elevated CA19-9 levels, especially above 1000 U/ml without jaundice, typically suggest malignancy with high specificity.
Observation:
- A case of obstructive jaundice due to a common bile duct stone with cholangitis presented with an extremely high CA19-9 level (61,800 U/ml).
- This prompted initial suspicion of a malignant cause.
Findings:
- Following successful treatment of the biliary obstruction, the patient's CA19-9 levels normalized.
- One year post-treatment, imaging revealed no signs of intra-abdominal malignancy.
Implications:
- Very high CA19-9 levels can be associated with benign conditions like obstructive jaundice, challenging its utility as a sole tumor marker.
- Accurate diagnosis requires successful treatment of biliary obstruction and potentially further invasive procedures to rule out malignancy.