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Relationship Between CA 19.9 and the Lewis Phenotype: Options to Improve Diagnostic Efficiency
Marina Parra-Robert1, Víctor Molina Santos2, Silvia Miró Canis3
1Oncobiology Unit, Department of Biochemistry and Molecular Genetics, Biomedical Diagnostic Center (CDB), Hospital Clínic, Barcelona, Spain.
Background/Aim:
Approximately 10% of patients are unable to synthesize CA 19.9 (Lewis-negative), and these results are erroneously considered false-negatives. The aim of this study was to confirm that CA 19.9 cannot be detected by immunoassays in Lewis-negative patients.
Materials And Methods:
CA 19.9 levels were measured by immunological assays and Lewis phenotype was determined by the haemagglutination reaction.
Results:
Patients with Lewis phenotype (a+b-) or (a-b+) had significantly higher CA 19.9 levels than Lewis-negative patients with active cancer (p<0.001), no-evidence of disease (NED) patients (p<0.001) or patients with benign disease (p<0.001). Ninenty-four percent of patients (33/35) with undetectable CA 19.9 had a Lewis-negative phenotype. Additionally, 94.7% (34/36) of patients with Lewis-negative phenotypes had undetectable CA 19.9 serum levels.
Conclusion:
Patients with undetectable CA 19.9 serum levels tend to be Lewis-negative, and CA 19.9 is not useful in diagnosis or follow-up.
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