The tumor marker CA 19-9 is a high molecular weight glycoprotein. It is produced by cells in the epithelium of the digestive system. As a research method, immunochemiluminescent analysis is used. CA 19-9 is associated with cancer pathologies.
general information
For research, venous blood is used as biological material. CA 19-9 is an effective tumor marker. Its definition is used in the diagnosis, monitoring and early detection of metastasis in the stomach, pancreas, liver, intestines (colon and rectum). The level of CA 19-9 is increased in almost all patients with gastrointestinal tumors, especially the pancreas. Being produced in neoplasm cells, glycoprotein penetrates into the systemic circulation. By observing and evaluating its content, specialists get the opportunity to monitor the course of pathology. Analysis of CA 19-9, the norm of which in a healthy person is not more than 10 units / ml, is not used in the initial diagnosis.
What is pancreatic cancer? Brief information
This cancer is today included in the list of the most dangerous pathologies. About 90% of patients die in the first year of the onset of the disease. By the time of diagnosis, 80% of patients have distant or regional metastases. Specialists attribute this mainly to the latent course of pathology. The disease is often masked by the inflammatory processes of the chronic course in the organs of the hepatopancreatoduodenal zone (gallstone disease, cholecystitis, chronic pancreatitis). In this regard, it is necessary to carry out differential diagnosis as soon as possible, excluding the presence of malignant neoplasms. This, in turn, will allow you to choose the most effective therapeutic tactics of these chronic pathologies.
Antigen CA 19-9. Concentration
In pancreatic cancer, there is a high level of glycoprotein. Analysis of CA 19-9, the norm of which is indicated above, is necessary when detecting carcinoma, assessing the possibility of resection. At a concentration of more than 1000 U / ml, the neoplasm is considered operable only in 5% of patients. If the content is lower than the indicated number, the tumor can usually be removed. However, after an intervention for one to seven months, the risk of relapse remains. The tumor marker CA 19-9 is considered the second most important marker after CEA for the detection of malignant neoplasms in the stomach. In addition, the study of high molecular weight glycoprotein is additionally assigned to alpha-fetoprotein in the diagnosis and monitoring of treatment of cancer of the liver, biliary tract and bladder.
Content increase
An increased level of glycoprotein can be observed against a background of various inflammatory and benign pathologies in the liver and digestive system (up to 500, but most often up to 100 PIECES / ml), as well as with cystic fibrosis. In the first case, the concentration is increased in 12% of patients. The maximum level in this case is not more than 45 units / ml. Glycoprotein is excreted with bile. In this regard, any cholestasis may be accompanied by an increase in its content. In such cases, it is necessary to simultaneously conduct a study of GGT (gamma-glutamate transferase) and alkaline phosphatase. An increase in concentration can also be observed against the background of tumors of a different location (with colorectal cancer, an ovarian tumor), liver pathologies (cirrhosis, hepatitis).
Missing or lowered
Experts note that a normal concentration does not exclude the presence of a malignant neoplasm in the pancreas. In this case, an early stage of the pathology can be diagnosed, when the level has not yet managed to rise. When conducting a study in patients receiving treatment, a decrease in glycoprotein may indicate the effectiveness of therapeutic measures.
Why research is needed
The test for the tumor marker CA 19-9 is necessary to monitor the effectiveness of therapeutic measures for pancreatic cancer, as well as for the timely detection of recurrence of pathology. The study allows the differential diagnosis of malignant neoplasms with other diseases (for example, pancreatitis). Indicator CA 19-9 indicates the prevalence of the malignant process, the presence of distant metastases against the background of cancer.
In what cases is a study prescribed
The CA 19-9 tumor marker test is recommended for symptoms of cancer in the pancreas: nausea, abdominal pain, jaundice, weight loss. The study is prescribed periodically to patients with initially high levels of glycoprotein and receiving treatment. The test is recommended for suspected cancer in the gallbladder or biliary tract, liver, stomach, or large intestine. The study is assigned in conjunction with other tests.
Decryption
The reference values in the range of which the antigen level should be - 0–35 U / ml. As mentioned above, a high concentration of glycoprotein indicates the presence of a malignant process in the pancreas. Moreover, the higher the content, the later the stage of pathology. Excessively high levels indicate tumor metastasis.
Important information
A test for the content of the glycoprotein in question is of particular importance in the early detection of metastasis of a malignant neoplasm in the pancreas. About 7-10% of people do not have a gene that encodes this high molecular weight glycoprotein. Accordingly, in the body there is no genetic opportunity to synthesize antigen CA 19-9. Thus, even when diagnosing a malignant neoplasm, the level of this glycoprotein is not determined in serum.
additional information
Before donating blood, experts recommend not smoking for half an hour. The diagnostic value of the test increases with a simultaneous study on CEA. In addition, tests for CA 72-4, total bilirubin, CA 242 are recommended for making the most accurate diagnosis and prescribing the necessary treatment. Laboratory tests are prescribed by specialists such as a hepatologist, therapist, surgeon or oncologist.
Conclusion
Experts note that today cancer in the pancreas is increasingly found in patients after 30 years. This pathology is considered one of the most difficult to diagnose and poorly amenable to therapy. In this regard, the most sensitive tests are needed to identify it. Unfortunately, the study of antigen concentration cannot be used to diagnose the initial stages of the development of the disease. Nevertheless, this test remains the most sensitive and informative for evaluating the effectiveness of treatment, identifying an early stage of metastasis of a malignant neoplasm. Undoubtedly, the specialist uses the results of various diagnostic measures during the examination. In addition to laboratory, instrumental studies are assigned to the patient. The most affordable of them today is ultrasound.
During its implementation, a specialist can detect a tumor the size of two centimeters. To clarify the size, position, as well as the spread of the malignant process, computed tomography is prescribed. Using this method, a tumor as small as three centimeters can be detected. It should be noted that CT is associated with a certain dose of x-ray radiation. Therefore, this study is not carried out often or as a prophylaxis. A lesser load on the patient's body has an MRI. But this type of research is not conducted for persons who have any metal implants. All these diagnostic measures, along with blood tests, reveal the early stages of development or metastasis of cancer in the pancreas.