Tumor markers have proven to be useful in monitoring the effect of therapy and are pertinent prognostic tools for clinical use. One of these tumor markers CA 19-9, is very useful in assessing patients with gastrointestinal tract malignancy,
especially
pancreatic cancer.
From January 1990 to December 1992. serum concentrations of CA 19-9 in 53 patients with pancreatobiliary tract cancer and 18 non-neoplastic diseases were determined at Kangnam St. Mary's Hospital to evaluate the clinical usefulness of this tumor
marker.
The mean value of CA 19-9 in benign disease(39.4±60.8u/ml) is not significantly elevated compared with cutoff value(37u/ml), but in malignant cancer group, the value(136.4±162.2u/ml) is markedly elevated compared with benign disease(p<0.01).
Sensitivity of CA 19-9 at a cutoff of 37u/ml in hepatoma is 37.5%, GB cancer 45.5%, ampulla of Vater cancer 66.7%, CBD cancer 77.8% and pancreatic cancer 100%. CBD and pancreatic cancer have higher than hepatoma, GB cnacer and ampulla of Vater
cancer(p<0.01). After operation, a significant fall in serum CA 19-9 value occurs in 13 cases(10 out of 17 resected cases and 3 of 1- bypass cases). But the mean value of resected group(60.2±88.4u/ml) is lower than bypass
group(155.4±94.8u/ml)(p<0.01). During follow-up period, CA 19-9 value is elevated in 3 out of 17 resected cases. These 3 cases are proved cancer recurrence by other imaging methods. In conclusion. the authors consider that CA 19-9 test is
valuable
for
detection of pancreas and CBD cancer, assessing response to therapy and evaluating early recurrence. (Korean J Gastroenterol 1994 ; 26 : 175-180)
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