Prevalence and clinical significance of enormously increased CA 19.9 concentrations in hospitalised patients
Poster
Data di Pubblicazione:
2013
Citazione:
Prevalence and clinical significance of enormously increased CA 19.9 concentrations in hospitalised patients / R. Mozzi, S. Ferraro, C. Valente, M. Panteghini. - In: BIOCHIMICA CLINICA. - ISSN 0393-0564. - 37:suppl.13(2013), pp. M197.S184-M197.S184. (Intervento presentato al convegno EUROMEDLAB tenutosi a Milano nel 2013).
Abstract:
Background: Markedly elevated CA 19.9 concentrations in
serum are regarded as specific enough to reliably identify
pancreatic cancer, even if a consistent body of literature shows
CA 19.9 concentrations >1000 kU/L in a variety of benign
conditions. Scarce data are, however, available on the
prevalence and clinical significance of CA 19.9 values >10,000
kU/L. Here we present a case series of consecutive patients
admitted to our hospital with CA 19.9 concentrations >10,000
kU/L, with the aim to assess the association of such
concentrations with the presence of pancreatic cancer and,
more in general, with tumours of the gastrointestinal system.
We also tried to define whether the exact measurement of CA
19.9 concentrations in this range, which needs serial sample
dilutions, is cost-effective.
Methods: CA 19.9 measurements, including a 1:10 sample
dilution in accordance to manufacturer’s instructions allowing
the determination of concentrations up to 10,000 kU/L, were
performed on Roche Modular EVO system. Samples with
higher CA 19.9 values were diluted according to a defined
laboratory protocol to obtain estimates up to 100,000 kU/L.
Results: During 14 months, 18 patients showing an enormous
elevation of CA 19.9 concentrations (11,568 to >100,000 kU/L)
were identified (55% males; median age 73.5 years, range: 58-
85). Accordingly, the yearly prevalence of hospitalized patients
tested for CA 19.9 and with marker concentrations >10,000
kU/L was 2.9%. All recruited patients were diagnosed as
malignancies: 15 had primary or secondary pancreatic cancer,
two had gastric cancer and one a cholangiocarcinoma. CA 19.9
concentrations ranged between >10,000-30,000 kU/L in 9
cases, >30,000-60,000 kU/L in two, >60,000-100,000 kU/L in
three and >100,000 kU/L in four cases, respectively. A surgical
resection of the tumour was performed in 5 patients,
independently of CA 19.9 concentrations. The median patient’s
survival was <6 months.
Conclusions: CA 19.9 concentrations >10,000 kU/L
unequivocally identify a gastrointestinal malignancy, more
frequently (~83%) a primary or secondary pancreatic cancer.
Exactly measuring CA 19.9 concentrations >10,000 kU/L after
multiple sample dilutions does not add relevant information for
patients’ prognosis and treatment.
Tipologia IRIS:
01 - Articolo su periodico
Elenco autori:
R. Mozzi, S. Ferraro, C. Valente, M. Panteghini
Link alla scheda completa: