title: Reference levels of the tumor markers carcinoembryonic antigen, the carbohydrate antigens 19-9 and 72-4, and cytokeratin fragment 19 using the Elecsys Relecsys 1010 analyzer in a normal population in Kuwait. The importance of the determination of local reference levels.
abstract: The tumor markers CEA, CA 19-9, CA 72-4 and CYFRA 21-1 were analyzed in a group of apparently healthy subjects (n=232) in Kuwait using the Elecsys Relecsys 1010 analyzer. The distribution of the tumour marker levels was analyzed separately in Kuwaitis (n=103), non-Kuwaitis (n=129), smokers (n=68), non-smokers (n=164), males (n=138) and females (n=94). The distribution of CEA was significantly different in Kuwaitis vs. non-Kuwaitis in the total population (p=0.033) and in non-smokers (p=0.049); in males vs. females in the total population (p<0.0001) and in non-smokers (p=0.0002); and in smokers vs. non-smokers in the total population (p<0.0001) using the non-parametric Mann-Whitney U test. None of the other tumour markers showed significant differences in the subgroups. The upper reference level was defined as the 95th percentile of the normal values in each group. A higher reference level of CEA was observed in smokers (vs. non-smokers) in the total population. Also higher reference levels of CEA were observed in males (vs. females) both in the total population and in non-smokers. In the total population the respective reference levels were: CEA: 4.4 microg/L, CA 19-9: 35 kU/L, CA 72.4: 2.4 kU/L, and CYFRA 21.1: 2.1 microg/L. These results were compared with data in the kit inserts and literature data. The impact of 95th percentiles in a local heterogeneous population is discussed.
authors.affiliation: Department of Surgery, Faculty of Medicine, Kuwait University, Safat.
authors.forename: A I
authors.initials: AI
authors.lastname: Behbehani
authors.forename: A
authors.initials: A
authors.lastname: Mathew
authors.forename: M
authors.initials: M
authors.lastname: Farghaly
authors.forename: A
authors.initials: A
authors.lastname: van Dalen
mesh_terms: D000328:Adult; D000367:Age Factors; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000096:biosynthesis*; D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen / Q000096:biosynthesis; D002272:Carcinoembryonic Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D007633:Keratins / Q000096:biosynthesis; D007730:Kuwait; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012907:Smoking
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; C083825:CA-72-4 antigen; D002272:Carcinoembryonic Antigen; D007633:Keratins