Usefulness of Carbohydrate Antigen 19-9 Test in Healthy People and Necessity of Medical Follow-up in Individuals with Elevated Carbohydrate Antigen 19-9 Level
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Carbohydrate antigen 19-9 (CA 19-9) is a tumor marker whose level is elevated in many types of cancers and other benign conditions. CA 19-9 levels are frequently found to be elevated in individuals during general health examinations. This study aimed to investigate the clinical characteristics of such individuals and to determine the need for medical follow-up. Methods: We investigated individuals who underwent a health inspection, including a serum CA 19-9 test, at our center. Their CA 19-9 levels, age, sex, body mass index (BMI), and personal and past histories were investigated. Additionally, subgroup analyses were performed for those who underwent follow-up study for the elevated CA 19-9 levels. Results: Of 58,498 subjects, 581 (1.0%) had elevated CA 19-9 levels. Multivariate analyses revealed that older age, female sex, lower BMI, and diabetes were independent predisposing factors for elevated CA 19-9 level. A subgroup analysis revealed that the causative conditions were identified in 129 of 351 subjects (36.8%). Among them, the causative conditions in 31 subjects (8.8%, including four cases of cancer and 15 of benign tumors) were not detected at the initial check-up and were found during the follow-up period. Conclusion: The use of CA 19-9 as a marker for cancer in healthy individuals is inappropriate. However, medical follow-up in individuals with elevated CA 19-9 levels may be useful because some causative diseases may be detected during follow-up.
Abstract
Background: Carbohydrate antigen 19-9 (CA 19-9) is a tumor marker whose level is elevated in many types of cancers and other benign conditions. CA 19-9 levels are frequently found to be elevated in individuals during general health examinations. This study aimed to investigate the clinical characteristics of such individuals and to determine the need for medical follow-up. Methods: We investigated individuals who underwent a health inspection, including a serum CA 19-9 test, at our center. Their CA 19-9 levels, age, sex, body mass index (BMI), and personal and past histories were investigated. Additionally, subgroup analyses were performed for those who underwent follow-up study for the elevated CA 19-9 levels. Results: Of 58,498 subjects, 581 (1.0%) had elevated CA 19-9 levels. Multivariate analyses revealed that older age, female sex, lower BMI, and diabetes were independent predisposing factors for elevated CA 19-9 level. A subgroup analysis revealed that the causative conditions were identified in 129 of 351 subjects (36.8%). Among them, the causative conditions in 31 subjects (8.8%, including four cases of cancer and 15 of benign tumors) were not detected at the initial check-up and were found during the follow-up period. Conclusion: The use of CA 19-9 as a marker for cancer in healthy individuals is inappropriate. However, medical follow-up in individuals with elevated CA 19-9 levels may be useful because some causative diseases may be detected during follow-up.
참고문헌 (23)
- Perkins GL, "Serum tumor markers", Am Fam Physician, 68, pp.1075~1082 (2003)
- Magnani JL, "The discovery, biology, and drug development of sialyl Lea and sialyl Lex", Arch Biochem Biophys, 426, pp.122~131 (2004)
- Satake K, "CA19-9 as a screening and diagnostic tool in symptomatic patients : the Japanese experience", Pancreas, 9, pp.703~706 (1994)
- Daamen LA, "Systematic review on the role of serum tumor markers in the detection of recurrent pancreatic cancer", HPB(Oxford), 20, pp.297~304 (2018)
- Choe JW, "Usefulness of CA 19-9 for pancreatic cancer screening in patients with new-onset diabetes", Hepatobiliary Pancreat Dis Int, 17, pp.263~268 (2018)
- Zhang Y, "Tumor markers CA19-9, CA242 and CEA in the diagnosis of pancreatic cancer : a meta-analysis", Int J Clin Exp Med, 8, pp.11683~11691 (2015)
- Kim HJ, "A new strategy for the application of CA19-9 in the differentiation of pancreaticobiliary cancer : analysis using a receiver operating characteristic curve", Am J Gastroenterol, 94, pp.1941~1946 (1999)
- Frebourg T, "The evaluation of CA 19-9 antigen level in the early detection of pancreatic cancer : a prospective study of 866 patients", Cancer, 62, pp.2287~2290 (1988)
- Goonetilleke KS, "Systematic review of carbohydrate antigen(CA 19-9)as a biochemical marker in the diagnosis of pancreatic cancer", Eur J Surg Oncol, 33, pp.266~270 (2007)
- 김남희, "Serum CEA and CA 19-9 Levels are Associated with the Presence and Severity of Colorectal Neoplasia", Yonsei Medical Journal, 58(5), pp.918~924 (2017), 연세대학교의과대학[DOI]
- Kim HR, "Increased CA 19-9level in patients without malignant disease", Clin Chem Lab Med, 47, pp.750~754 (2009)
- Shimomura C, "Elevation of a tumor associated antigen CA 19-9 levels in patients with rheumatic diseases", J Rheumatol, 16, pp.1410~1415 (1989)
- Xiaofang Y, "Serum tumour markers in patients with chronic kidney disease", Scand J Clin Lab Invest, 67, pp.661~667 (2007)
- Sagi-Dain L, "CA 19-9 in evaluation of adnexal mass : retrospective cohort analysis and review of the literature", Int J Biol Markers, 30, pp.e333~e340 (2015)
- Kim JY, "Elevated serum CA 19-9 at screening tests : underlying conditions and role of abdominopelvic CT", Eur Radiol, 24, pp.2435~2448 (2014)
- Locker GY, "ASCO 2006 update of recommendations for the use of tumor markers in gastrointestinal cancer", J Clin Oncol, 24, pp.5313~5327 (2006)
- Kim JE, "Clinical usefulness of carbohydrate antigen 19-9 as a screening test for pancreatic cancer in an asymptomatic population", J Gastroenterol Hepatol, 19, pp.182~186 (2004)
- Kim BJ, "How do we interpret an elevated carbohydrate antigen 19-9 level in asymptomatic subjects", Dig Liver Dis, 41, pp.364~369 (2009)
- Wang HY, "Cancers screening in an asymptomatic population by using multiple tumour markers", PLoS One, 11, pp.e0158285~ (2016)
- Tong Y, "Study of an elevated carbohydrate antigen 19-9concentration in a large health check-up cohort in China", Clin Chem Lab Med, 51, pp.1459~1466 (2013)
- Ben Q, "The relationship between new-onset diabetes mellitus and pancreatic cancer risk : a casecontrol study", Eur J Cancer, 47, pp.248~254 (2011)
- Uygur-Bayramicli O, "Type 2 diabetes mellitus and CA 19-9 levels", World J Gastroenterol, 13, pp.5357~5359 (2007)
- Haugvik SP, "Diabetes, smoking, alcohol use, and family history of cancer as risk factors for pancreatic neuroendocrine tumors : a systematic review and meta-analysis", Neuroendocrinology, 101, pp.133~142 (2015)