Low efficacy of serum levels of CA 19-9 in prediction of malignant diseases in asymptomatic population in Taiwan.

Abstract

BACKGROUND/AIMS:

Serum levels of carbohydrate antigen (CA) 19-9 have long been employed as a biomarker in diagnosing pancreatic cancer in symptomatic patients. We assessed the clinical usefulness of serum CA 19-9 in screening pancreatic cancer and other malignancies in individuals without symptoms.

METHODOLOGY:

The study enrolled 5,343 consecutive asymptomatic individuals who completed a health check-up comprising serum CA 19-9, chest film, abdominal ultrasonography, esophagogastroduodenoscopy, and colonoscopy or sigmoidoscopy. The sensitivity, specificity and positive predictive rate of CA 19-9 in detecting cancers were analyzed.

RESULTS:

There were 385 patients (7.2%) with CA 19-9 higher than 37 U/mL. Two patients diagnosed with pancreatic cancer had CA 19-9 levels of 46,885 U/mL and 88.4 U/mL, respectively. Thirteen among 58 patients with other cancers had CA 19-9 levels higher than 37 U/mL. If the cut-off value of CA 19-9 was set at 37 U/mL, the sensitivity and specificity for pancreatic cancer and other cancers were 100% and 92.8%, as well as 22.4% and 92.9%, respectively. However, the positive predictive rates for pancreatic cancer and other cancers were as low as 0.5% and 3.4%, respectively.

CONCLUSIONS:

Efficacy of CA 19-9 in predicting either pancreatic cancer or other cancers in the asymptomatic population is low.

• Authors: Chi-Yang Chang, Shih-Pei Huang, Han-Mo Chiu, Yi-Chia Lee, Min-Fong Chen, Jaw-Town Lin
• Journal: Hepato-gastroenterology (Hepatogastroenterology) 2006 Jan-Feb Vol. 53 Issue 67 Pg. 1-4 ISSN: 0172-6390 [Print] Greece
• PMID: 16506366 (Publication Type: Journal Article)

Chemical References

• CA-19-9 Antigen

Topics

• Adult
• Aged
• CA-19-9 Antigen (blood)
• Digestive System Neoplasms (blood, diagnosis)
• Female
• Humans
• Male
• Middle Aged
• Predictive Value of Tests
• Taiwan