title: Elevated serum CA 19-9 at screening tests: underlying conditions and role of abdominopelvic CT.
abstract: OBJECTIVE
  To investigate underlying conditions of patients with elevated CA 19-9 at screening tests and to evaluate diagnostic performance of abdominopelvic CT.
  
  
  METHODS
  One hundred and thirteen patients with elevated CA 19-9 (>37 U/ml) who underwent abdominopelvic CT in a screening program were selected. Underlying conditions were determined by reviewing all available data and follow-up records. Patients were categorized into malignancy, benign, and normal/non-related disease groups. Their mean CA 19-9 and percent of patients with CA 19-9 ≥ 100 U/ml were compared. Diagnostic sensitivity of CT for detecting underlying conditions of elevated CA 19-9 was analysed.
  
  
  RESULTS
  Seventeen patients (17/113, 15 %) had 17 elevated CA 19-9-related malignancies, and 55 patients (55/113, 48.7 %) had 70 benign diseases. Mean CA 19-9 and percent of patients with CA 19-9 ≥ 100 U/ml in the malignancy group were significantly higher than in the two other groups. CT detected all except one malignant lesion with a detection sensitivity of 94.1 % (16/17). Of 70 CA 19-9-related benign diseases, CT detected 34 benign diseases (48.6 %) providing an alternative diagnosis for elevated CA 19-9.
  
  
  CONCLUSIONS
  Abdominopelvic CT is not only useful in detecting malignancies, but can also diagnose alternative benign causes of elevated CA 19-9 in asymptomatic screening tests.
  
  
  CONCLUSIONS
  • Fifteen percent of asymptomatic patients with elevated CA19-9 may have intra-abdominal malignancies. • Mean value of CA19-9 is different among malignant, benign, and non-related groups. • CT shows excellent sensitivity for intra-abdominal malignancies as causatives of elevated CA19-9. • CT provides alternative benign diagnoses as causatives of elevated CA19-9. • Detection of causatives of elevated CA19-9 using CT alleviates concerns and uncertainty.
authors.affiliation: Department of Radiology and Molecular Imaging Research Center, University of Louisville, Louisville, KY, USA.
authors.forename: Ji Yang
authors.initials: JY
authors.lastname: Kim
authors.forename: Se Hyung
authors.initials: SH
authors.lastname: Kim
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Kim
mesh_terms: D000008:Abdominal Neoplasms / Q000097:blood / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D018395:CA-19-9 Antigen / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010388:Pelvis / Q000000981:diagnostic imaging; D012372:ROC Curve; D011860:Radiography, Abdominal / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen
references.citation: J Clin Oncol. 2006 Nov 20;24(33):5313-27
references.pmid: 17060676
references.citation: Am J Gastroenterol. 2000 Jan;95(1):204-7
references.pmid: 10638584
references.citation: Dis Markers. 2013;34(4):219-28
references.pmid: 23396291
references.citation: Pancreas. 1994 Nov;9(6):703-6
references.pmid: 7846012
references.citation: Cytopathology. 2000 Feb;11(1):4-7
references.pmid: 10714370
references.citation: Minerva Gastroenterol Dietol. 2007 Dec;53(4):305-9
references.pmid: 18043548
references.citation: Eur J Intern Med. 2002 Mar;13(2):132-135
references.pmid: 11893472
references.citation: J Clin Lab Anal. 2007;21(3):193-6
references.pmid: 17506483
references.citation: J Gastrointest Surg. 1997 Mar-Apr;1(2):106-12
references.pmid: 9834336
references.citation: Eur J Surg Oncol. 2007 Apr;33(3):266-70
references.pmid: 17097848
references.citation: Int J Urol. 2006 Nov;13(11):1380-4
references.pmid: 17083387
references.citation: Gastroenterol Clin Biol. 1998 Feb;22(2):152-9
references.pmid: 9762189
references.citation: Pathol Int. 1999 Apr;49(4):310-7
references.pmid: 10365850
references.citation: Int J Cancer. 1997 Apr 22;74(2):233-6
references.pmid: 9133462
references.citation: Intern Med. 1998 Jan;37(1):91-3
references.pmid: 9510409
references.citation: Surg Neurol. 1993 Oct;40(4):284-8
references.pmid: 8211638
references.citation: Acta Paediatr. 2003 Nov;92(11):1267-71
references.pmid: 14696845
references.citation: J Gastroenterol Hepatol. 2005 Sep;20(9):1379-84
references.pmid: 16105124
references.citation: Am Fam Physician. 2003 Sep 15;68(6):1075-82
references.pmid: 14524394
references.citation: Urol Int. 1990;45(1):1-3
references.pmid: 2154875
references.citation: Dig Dis Sci. 2005 Apr;50(4):694-5
references.pmid: 15844704
references.citation: Surg Today. 2003;33(9):714-7
references.pmid: 12928854
references.citation: Cancer Detect Prev. 1999;23(2):116-22
references.pmid: 10101592
references.citation: Ann N Y Acad Sci. 2007 Jun;1108:359-71
references.pmid: 17893999
references.citation: Scand J Urol Nephrol. 2004;38(5):359-65
references.pmid: 15764245
references.citation: Eur J Surg Oncol. 2000 Aug;26(5):474-9
references.pmid: 11016469
references.citation: Int J Urol. 2007 Dec;14(12):1103-6
references.pmid: 18036053
references.citation: Hepatogastroenterology. 2006 Jan-Feb;53(67):1-4
references.pmid: 16506366
references.citation: Clin Exp Obstet Gynecol. 2008;35(2):137-9
references.pmid: 18581770
references.citation: J Gastroenterol Hepatol. 2004 Feb;19(2):182-6
references.pmid: 14731128
references.citation: Dig Dis Sci. 2007 Sep;52(9):2221-4
references.pmid: 17443412
references.citation: World J Gastroenterol. 2007 Oct 28;13(40):5357-9
references.pmid: 17879406
references.citation: Clin Chem Lab Med. 2009;47(6):750-4
references.pmid: 19402792
references.citation: HPB (Oxford). 2004;6(1):43-4
references.pmid: 18333046
references.citation: World J Gastroenterol. 2013 Aug 28;19(32):5302-8
references.pmid: 23983433