Yıl: 2020 Cilt: 19 Sayı: 1 Sayfa Aralığı: 5 - 10 Metin Dili: İngilizce DOI: 10.17941/agd.728662 İndeks Tarihi: 30-12-2020

Carbohydrate antigen 19-9 levels in early acute pancreatitis

Öz:
There are many etiologic factors responsiblefor acute pancreatitis. Carbohydrate antigen 19-9 is a well-known tumormarker for gastrointestinal malignancies, especially pancreaticobiliarycancer. Carbohydrate antigen 19-9 levels also increase benignevents such as cholestasis. Therefore, the purpose of this study is toretrospectively investigate the relationship between the underlyingetiologies and carbohydrate antigen 19-9 levels in patients who werehospitalized due to acute pancreatitis. Materials and Methods: Weretrospectively analyzed the data of 109 patients who had increasedcarbohydrate antigen 19-9 levels in the first 24 hours during hospitalization.Additionally, we divided the patients into two groups, namelybiliary and nonbiliary, based on their recent diagnoses in the etiologiesof acute pancreatitis. Results: We detected increased carbohydrate antigen19-9 levels (more than 37 U/mL) in 63 (92%) of the patients inthe biliary group, and in 8 (19%) of the patients in the non-biliary group(p <0.001). There was a statistically significant difference between thegroups regarding the mean carbohydrate antigen 19-9 values (164.5vs. 24.1 U/mL, respectively; p <0.005). Also, aspartate aminotransferase,alanine aminotransferase, total bilirubin, and direct bilirubin valueswere statistically different between the two groups (p <0.05). The receiveroperating characteristic curve analysis suggested that the optimumcarbohydrate antigen 19-9 level cut-off point for the prediction ofpancreatitis caused by biliary reasons was 39.6 U/mL, with a sensitivityand specificity of 92.6% and 85.4%, respectively. Conclusion: Highlevels of carbohydrate antigen 19-9 (especially above 39.6 U/mL) inpatients with acute pancreatitis may be associated with biliary acutepancreatitis.
Anahtar Kelime:

Akut pankreatitte karbonhidrat antijen 19-9 seviyeleri

Öz:
Akut pankreatit için birçok etiyolojik faktör bulunmaktadır. Karbonhidrat antijeni 19-9, gastrointestinal malignitelerde, özellikle pankreatikobiliyer kanserde iyi bilinen tümör belirtecidir. Karbonhidrat antijeni 19-9 seviyeleri ayrıca kolestaz gibi iyi huylu hadiselerde de artış gösterir. Bu nedenle akut pankreatit nedeniyle hastanede yatan hastalarda altta yatan etiyolojiler ile karbonhidrat antijeni 19-9 düzeyleri arasındaki ilişkiyi retrospektif olarak araştırmayı amaçladık. Gereç ve Yöntem: Hastanede yatış sırasında ilk 24 saatte karbonhidrat antijeni 19-9 düzeyi bakılan 109 hastanın verilerini retrospektif olarak inceledik. Hastalar akut pankreatit etiyolojisindeki son tanılarına dayanarak biliyer ve non-biliyer olarak iki gruba ayrıldı. Bulgular: Biliyer gruptaki hastaların 63’ünde (%92), non-biliyer gruptaki hastaların 8’inde (%19) karbonhidrat antijeni 19-9 düzeyi 37 U/mL’den yüksek saptandı (p <0.001). Gruplar arasında ortalama karbonhidrat antijeni 19-9 değerleri açısından istatistiksel olarak anlamlı fark vardı (164.5’e karşı 24.1; p <0.005). Ayrıca aspartat aminotransferaz, alanin aminotransferaz, total bilirübin ve direkt bilirübin değerleri iki grup arasında istatistiksel olarak farklıydı (p <0.05). Receiver operating characteristic eğri analizinde, biliyer nedenlerden dolayı pankreatitin öngörülmesi için optimum karbonhidrat antijeni 19-9 seviyesi kesme noktasının sırasıyla %92.6 ve %85.4 duyarlılık ve özgüllük ile 39.6 U/mL olduğunu görülmüştür. Sonuç: Akut pankreatitli hastalarda yüksek karbonhidrat antijeni 19-9 (özellikle 39.6 U/mL’nin üzerinde) düzeyleri, biliyer nedenli akut pankreatitle ilişkili olabilir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Kaya E, Dervişoğlu A, Polat C. Evaluation of diagnostic findings and scoring systems in outcome prediction in acute pancreatitis. World J Gastroenterol 2007;13:3090-4.
  • 2. Kasap E, Akyıldız M, Tekin F, et al. Angiotensin-converting enzyme genotype and acute pancreatitis in Turkey. Balk J Med Genet (BJMG) 2009;12:39-44.
  • 3. Cüre E, Basturk A, Şahin M, et al. The evaluation of tumor markers in acute pancreatitis. Turk J Cancer. 2007;37:11-5.
  • 4. Al-Jiffry BO, Khayat S, Abdeen E, Hussain T, Yassin M. A scoring system for the prediction of choledocholithiasis: a prospective cohort study. Ann Saudi Med 2016;36:57-63.
  • 5. Sherman JL, Shi EW, Ranasinghe NE, et al. Validation and improvement of a proposed scoring system to detect retained common bile duct stones in gallstone pancreatitis. Surgery 2015;157:1073-9.
  • 6. Kim MS, Jeon TJ, Park JY, et al. Clinical interpretation of elevated CA 19-9 levels in obstructive jaundice following benign and malignant pancreatobiliary disease. Korean J Gastroenterol 2017;70:96- 102.
  • 7. Marrelli D, Caruso S, Pedrazzani C, et al. CA19-9 serum levels in obstructive jaundice: clinical value in benign and malignant conditions. Am J Surg 2009;198:333-9.
  • 8. Ong S, Sachdeva A, Garcea G, et al. Elevation of carbohydrate antigen 19.9 in benign hepatobiliary conditions and its correlation with serum bilirubin concentration. Dig Dis Sci 2008;53:3213-7.
  • 9. Akimoto S, Banshodani M, Nishihara M, et al. Acute cholecystitis with significantly elevated levels of serum carbohydrate antigen 19- 9. Case Rep Gastroenterol 2016;10:410-6.
  • 10. Mann DV, Edwards R, Ho S, Lau WY, Glazer G. Elevated tumour marker CA19-9: clinical interpretation and influence of obstructive jaundice. Eur J Surg Oncol 2000;26:474-9.
  • 11. Albert MB, Steinberg WM, Henry JP. Elevated serum levels of tumor marker CA19-9 in acute cholangitis. Dig Dis Sci 1988;33:1223- 5.
  • 12. Richter JM, Christensen MR, Rustgi AK, Silverstein MD. The clinical utility of the CA19-9 radioimmunoassay for the diagnosis of pancreatic cancer presenting as pain or weight loss: a cost-effectiveness analysis. Arch Intern Med 1989;149:2292-7.
  • 13. Paganuzzi M, Onetto M, Marroni P, et al. CA 19‐9 and CA 50 in benign and malignant pancreatic and biliary diseases. Cancer 1988;61:2100-8.
  • 14. Patel AH, Harnois DM, Klee GG, LaRusso NF, Gores GJ. The utility of CA 19-9 in the diagnoses of cholangiocarcinoma in patients without primary sclerosing cholangitis. Am J Gastroenterol 2000;95:204-7.
  • 15. Katsanos KH, Kitsanou M, Christodoulou DK, Tsianos EV. High CA 19-9 levels in benign biliary tract diseases: report of four cases and review of the literature. Eur J Intern Med 2002;13:132-5.
  • 16. Lowe D, Lee J, Schade R, Chaudhary A. Patient with markedly elevated CA 19-9 not associated with malignancy. South Med J 2006;99:306-8.
  • 17. Sanchez M, Gomes H, Marcus EN. Elevated CA 19-9 levels in a patient with Mirizzi syndrome: case report. South Med J 2006;99:160-4.
  • 18. Marcouizos G, Ignatiadou E, Papanikolaou GE, et al. Highly elevated serum levels of CA 19-9 in choledocholithiasis: a case report. Cases J 2009;2:6662.
  • 19. Bertino G, Ardiri AM, Calvagno GS, et al. Carbohydrate 19.9 antigen serum levels in liver disease. Biomed Res Int 2013;2013:531640.
  • 20. Shin JY, Yoo SJ, Park BM, et al. Extremely increased serum carbohydrate antigen 19-9 levels caused by new or resistant infections to previous antibiotics in chronic lung diseases. Tuberc Respir Dis (Seoul) 2013;75:125-7.
  • 21. Su SB, Qin SY, Chen W, Luo W, Jiang HX. Carbohydrate antigen 19-9 for differential diagnosis of pancreatic carcinoma and chronic pancreatitis. World J Gastroenterol 2015;21:4323-33.
  • 22. Hong JY, Jang SH, Kim SY, et al. Elevated serum CA 19-9 levels in patients with pulmonary nontuberculous mycobacterial disease. Braz J Infect Dis 2016;20:26-32.
  • 23. Videhult P, Sandblom G, Rudberg C, Rasmussen IC. Are liver function tests, pancreatitis and cholecystitis predictors of common bile duct stones? Results of a prospective, population-based, cohort study of 1171 patients undergoing cholecystectomy. HPB (Oxford) 2011;13:519-27.
  • 24. Kim H-J, Kim M-H, Myung S-J, et al. A new strategy for the application of CA19-9 in the differentiation of pancreaticobiliary cancer: analysis using a receiver operating characteristic curve. Am J Gastroenterol 1999;94:1941-6.
  • 25. Goonetilleke K, Siriwardena A. Systematic review of carbohydrate antigen (CA 19-9) as a biochemical marker in the diagnosis of pancreatic cancer. Eur J Surg Oncol 2007;33:266-70.
  • 26. Marrelli D, Pinto E, De Stefano A, et al. Clinical utility of CEA, CA 19-9, and CA 72-4 in the follow-up of patients with resectable gastric cancer. Am J Surg 2001;181:16-9.
  • 27. Stiksma J, Grootendorst DC, van der Linden PWG. CA 19-9 as a marker in addition to CEA to monitor colorectal cancer. Clin Colorectal Cancer 2014;13:239-44.
  • 28. Scarpa M, Noaro G, Saadeh L, et al. Esophageal cancer management: preoperative CA19. 9 and CEA serum levels may identify occult advanced adenocarcinoma. World J Surg 2015;39:424-32.
  • 29. Song Y-x, Huang X-z, Gao P, et al. Clinicopathologic and prognostic value of serum carbohydrate antigen 19-9 in gastric cancer: a meta- analysis. Dis Markers 2015;2015:549843.
  • 30. Morris-Stiff G, Teli M, Jardine N, Puntis MC. CA 19-9 antigen levels can distinguish between benign and malignant pancreaticobiliary disease. Hepatobiliary Pancreat Dis Int 2009;8:620-6.
  • 31. Teng D, Wu K, Sun Y, et al. Significant increased CA 19-9 levels in acute pancreatitis patients predicts the presence of pancreatic cancer. Oncotarget 2018;9:12745-53.
  • 32. Roberts SE, Morrison-Rees S, John A, et al. The incidence and aetiology of acute pancreatitis across Europe. Pancreatology 2017;17:155-65.
APA binicier o, Pakoz Z (2020). Carbohydrate antigen 19-9 levels in early acute pancreatitis. , 5 - 10. 10.17941/agd.728662
Chicago binicier omer,Pakoz Zehra Betul Carbohydrate antigen 19-9 levels in early acute pancreatitis. (2020): 5 - 10. 10.17941/agd.728662
MLA binicier omer,Pakoz Zehra Betul Carbohydrate antigen 19-9 levels in early acute pancreatitis. , 2020, ss.5 - 10. 10.17941/agd.728662
AMA binicier o,Pakoz Z Carbohydrate antigen 19-9 levels in early acute pancreatitis. . 2020; 5 - 10. 10.17941/agd.728662
Vancouver binicier o,Pakoz Z Carbohydrate antigen 19-9 levels in early acute pancreatitis. . 2020; 5 - 10. 10.17941/agd.728662
IEEE binicier o,Pakoz Z "Carbohydrate antigen 19-9 levels in early acute pancreatitis." , ss.5 - 10, 2020. 10.17941/agd.728662
ISNAD binicier, omer - Pakoz, Zehra Betul. "Carbohydrate antigen 19-9 levels in early acute pancreatitis". (2020), 5-10. https://doi.org/10.17941/agd.728662
APA binicier o, Pakoz Z (2020). Carbohydrate antigen 19-9 levels in early acute pancreatitis. Akademik Gastroenteroloji Dergisi, 19(1), 5 - 10. 10.17941/agd.728662
Chicago binicier omer,Pakoz Zehra Betul Carbohydrate antigen 19-9 levels in early acute pancreatitis. Akademik Gastroenteroloji Dergisi 19, no.1 (2020): 5 - 10. 10.17941/agd.728662
MLA binicier omer,Pakoz Zehra Betul Carbohydrate antigen 19-9 levels in early acute pancreatitis. Akademik Gastroenteroloji Dergisi, vol.19, no.1, 2020, ss.5 - 10. 10.17941/agd.728662
AMA binicier o,Pakoz Z Carbohydrate antigen 19-9 levels in early acute pancreatitis. Akademik Gastroenteroloji Dergisi. 2020; 19(1): 5 - 10. 10.17941/agd.728662
Vancouver binicier o,Pakoz Z Carbohydrate antigen 19-9 levels in early acute pancreatitis. Akademik Gastroenteroloji Dergisi. 2020; 19(1): 5 - 10. 10.17941/agd.728662
IEEE binicier o,Pakoz Z "Carbohydrate antigen 19-9 levels in early acute pancreatitis." Akademik Gastroenteroloji Dergisi, 19, ss.5 - 10, 2020. 10.17941/agd.728662
ISNAD binicier, omer - Pakoz, Zehra Betul. "Carbohydrate antigen 19-9 levels in early acute pancreatitis". Akademik Gastroenteroloji Dergisi 19/1 (2020), 5-10. https://doi.org/10.17941/agd.728662