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[Increased serum CA 19.9 in bronchiectasis].
1Service de Médecine Interne, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium.
Revue Des Maladies Respiratoires
|February 22, 2008
Summary
Elevated cancer antigen 19.9 (CA 19.9) levels, typically a marker for pancreatic cancer, can occur in benign lung conditions like bronchiectasis. This case highlights that CA 19.9 is not a reliable screening tool for cancer.
Area of Science:
- Oncology
- Pulmonology
- Clinical Diagnostics
Background:
- Carbohydrate antigen 19.9 (CA 19.9) is a sensitive marker for pancreatic adenocarcinoma.
- Elevated CA 19.9 levels can also be observed in non-neoplastic conditions, including benign pulmonary diseases.
- Significantly increased CA 19.9 in bronchiectasis is rare.
Observation:
- A 67-year-old woman incidentally presented with serum CA 19.9 levels over 1500 U/ml (normal <37 U/ml).
- Extensive investigations ruled out digestive malignancy.
- Positron emission tomography, CT scans, and bronchoscopy revealed bilateral bronchiectasis with Haemophilus influenzae infection.
Findings:
- Antibiotic treatment led to a partial decrease in CA 19.9 levels.
- CA 19.9 remained abnormally elevated for over two years despite treatment.
- The findings suggest a strong association between bronchiectasis and persistently high CA 19.9 levels.
Implications:
- This case underscores the limitations of using CA 19.9 as a standalone screening test for pancreatic cancer.
- Tumor markers can yield false positives in the presence of benign conditions like bronchiectasis.
- Relying solely on CA 19.9 for cancer screening may lead to unnecessary anxiety and further invasive testing.
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