Elevated Carbohydrate Antigen 19-9 Does Not Necessarily Mean Cancer

In more than one third of patients, increased serum CA 19-9 levels were associated with benign hepatic conditions or unrelated to any known risk factors.

Cholangiocarcinoma (CCA) is a serious complication of primary sclerosing cholangitis (PSC). It is typically diagnosed at an advanced stage and can occur in the absence of cirrhosis. Although no screening guidelines exist, elevated serum carbohydrate antigen 19-9 (CA 19-9) levels have been associated with CCA and are used as a screening indicator. However, elevated CA 19-9 levels are also associated with other conditions, including pancreatic cancer, chronic pancreatitis, cholangitis, and cholestasis.

To evaluate long-term outcomes of patients with PSC and elevated CA 19-9 levels (>129 U/mL), particularly those without CCA, investigators retrospectively examined clinical data for 73 patients. PSC was diagnosed based on cholangiographic result…

Reviewing Author

Atif Zaman, MD, MPH