Normal and abnormal values of cancer marker CA 19-9

CA 19-9 is a tumor indexer used in the diagnosis, evaluation of the patient's response to treatment and monitoring of patients with pancreatic or hepatic – bile cancer. In the diagnosis of pancreatic cancer, the presence of symptoms of embolism or bile obstruction and an increased CA 19-9 dosing index will help the doctor conclude the risk of pancreatic cancer instead of benign pancreatic tumors. Similarly, patients with ascites, jaundice symptoms and increased CA19-9 test results are at increased risk for liver cancer.

1. What is the normal CA 19-9 dosing?

The normal CA 19-9 dosing index in plasma or serum is ≤ 37 U/mL. The normal value of CA 19-9 may vary slightly depending on the dosing method, analyzeer system and usage terms of each laboratory.

2. CA 19-9 in pancreatic cancer risk diagnosis

CA 19-9 is a cancer marker with a sensitivity of 79 – 81% and a specificity of 82 – 90% for the diagnosis of pancreatic cancer in patients with suspected symptoms. With a threshold value of 37 U/mL, the diagnostic sensitivity of pancreatic cancer is 81% (68% – 93%), the specificity is 90% (76% – 100%). However, when the level of CA 19-9 increases to more than 1000 U/mL, the diagnostic sensitivity of pancreatic cancer is 41% (68% – 93%), the specificity is 99.8%.

3. CA 19-9 in pancreatic cancer assessment

The increased rate of CA 19-9 is associated with the location of the tumor with the threshold of >37 U/mL, the tumor at the head of the pancreas, the rate of increase of CA 19-9 is 80%, when the tumor is in the body and in the pancreatic tail, the rate of increase of CA 19-9 is 57%.

The increased rate of CA 19-9 is correlation with the disease phase with the threshold of >120 U/mL: when pancreatic cancer is at stage T2/3, the rate of increase in CA 19-19-mL 9 is 33%, in the T + N1 stage, the CA increase rate of 19-9 is 71%, in the TN + M1 stage, the ca increase rate of 19-9 is 85%.

The increased rate of CA 19-9 is also correlation with tumor size with a threshold of 37 U/mL: when the tumor size <3 cm="" thì="" tỷ="" lệ="" tăng="" ca="" 19-9="" là="" 57%,="" khi="" kích="" thước="" khối="" u="" 3-6="" cm="" thì="" tỷ="" lệ="" tăng="" ca="" 19-9="" là="" 80%,="" khi="" kích="" thước="" khối="" u=""> is 6 cm the rate of increase of CA 19-9 is 100%.</3>

When CA 19-9 levels are high >1000 U/ mL, the diagnostic value of pancreatic cancer is positive and specificity is about 100% and there is no longer the possibility of surgical removal.

4. CA 19.9 in monitoring for treatment response and pancreatic cancer

The decrease in the CA 19-9 plasma index after pancreatic surgery shows the therapeutic response and is proportional to the patient's survival time. On the contrary, the increased level of CA 19-9 plasma after pancreatic surgery will be proportional to the likelihood of recurrence and inversely proportional to the patient's survival time.

5. CA 19.9 test results in pancreatic cancer recurrence assessment

Normal and abnormal values of cancer marker CA 19-9

CA 19.9 Testing

Normal levels of CA 19-9 pre-surgery plasma<37 u/="" ml)="" thì="" bệnh="" nhân="" có="" thời="" gian="" sống="" trung="" bình="" là="" 32="" -="" 36="" tháng,="" dài="" hơn="" so="" với="" bệnh="" nhân="" có="" mức="" độ="" ca="" 19-9="" tăng="" (="">(37 U/mL) have an average life time of only 12-15 months.</37>

After surgical restomizationor chemotherapy, the level of CA 19-9 plasma returns to normal or decreases by ≥ 20-50% compared to the original level, the patient's survival time will be longer than if the level of CA 19-9 cannot return to normal or increase.

6. Ca 19-9 dosing index in some other cancers

The level of CA 19-9 plasma may increase in some other cancerssuch as liver, bile, stomach, colorectal, ovarian, esophagus …

6.1. CA 19-9 in hepatic cell meacular cancer (HCC)

The clinical sensitivity of the CA 19-9 index in hepatic cell hisbular cancer is 22-49%.

6.2. CA 19-9 in bile ingthway cancer

The sensitivity of CA 19-9 to >100 U/mL threshold in the diagnosis of bile sugars is 53%. To distinguish between benign and malignant bile obstruction should choose a CA threshold of 19-9 of 200 U/mL (with a sensitivity of 65% and a specificity of 91%) more suitable than the threshold of 37 U/mL (sensitivity 83% and specificity 45%). Combining a CA threshold of 19-9 > 200 U/mL together with a CEA > threshold of 5 ng/mL will help best distinguish hepatic cell carotid carotid cancer (HCC) from acute or non-bile otitis.

6.3. CA 19-9 in stomach cancer

The clinical sensitivity of the CA 19-9 index in stomach cancer is 26-60% and depends on the stage of cancer. The combination of CA 19-9 and CEA marker doubles clinical sensitivity, and is also a prenast factor that helps assess the level of invasiveness, liver metaosis and stage of cancer.

6.4. CA 19-9 in colorectal cancer

In colorectal cancer , the sensitivityof CA 19-9 (18-58%) lower than the sensitivity of the CEA mark (38-58%). The increased rate of CA 19-9 in colorectal cancer depends on the cancer stage (Dukes A stage is 0-7%, Dukes B is 17%, Dukes C is 47% and Dukes D is 75%). Meanwhile, the increased rate of CEA in the stages of colorectal cancer is much higher (Dukes A stage is < 20%, Dukes B là 40-60%, Dukes C là 60-80% và Dukes D là 80-85%).

6.5. For the remaining cancers

The sensitivity of CA 19-9 in the diagnosis of some other cancers is generally low: for lung cancer the sensitivity is 7-42%, for breast cancer is 10%, ovarian cancer is 15-38% (68-88%, can not be 25-29%) and for uterus cancer is only 13%.

Normal and abnormal values of cancer marker CA 19-9

7. CA 19-9 in some benign diseases

Increased levels of CA 19-9 plasma can also be increased in some benign diseases such as: bile obstruction, bile arthritis, enteritis, acute or chronic pancreatitis, cirrhosis of the liver, cystic fibrosis, thyroid disease. About 10-30% of cases have a transient 19-9 increase in CA, depending on the activity and degree of the disease. This increase is usually <100 U/mL, tối đa là khoảng 500 U/mL hoặc tăng nhẹ dai dẳng, cần theo dõi ít nhất trong khoảng 2 tuần.

SEE MORE:

  • Learn about cancer marker CA 72-4
  • The meaning of CEA dosing finds cancer markers
  • What are tumor markers?

SEE MORE:

  • What does the low Pepsinogen I index warn?
  • What does the SCC mean?
  • What are the meanings of CEA and CA 19-9?

About: John Smith

b1ffdb54307529964874ff53a5c5de33?s=90&r=gI am the author of Share99.net. I had been working in Vinmec International General Hospital for over 10 years. I dedicate my passion on every post in this site.

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