Guest guest Posted May 21, 2008 Report Share Posted May 21, 2008 Hi Barbara, Those numbers sound very high, but I see they've been high for over a year and a half. What does his Doctor say? and what are they doing to treat it? Ian (52) PSC 69 My husband had a CA 19-9 test this week and the numbers are high. He's had the test 3 times and they were all high. I would appreciate if anyone would tell me what this all means? I have done some research and know a little bit but I need more information. Here are the numbers: 5/20/08 - 1473; 12/18/06 - 1475; 12/4/06 - 1774. Barbara (wife of (PSC 07, Panc surg 1/07, chronic panc, gallbladder 7/06, HE, etc.) -- Ian Cribb former P.Eng. (resigned in good standing) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 2008 Report Share Posted May 21, 2008 Dear Barbara; You can find over 100 references on CA 19-9 here: http://www.psc-literature.org/CA19-9.htm I'll try to summarize some of the key points: 1. Some researchers use elevated CA 19-9 (> 100) as a potential marker for early detection of cholangiocarcinoma in PSC. Gores GJ 2000 Early detection and treatment of cholangiocarcinoma. Liver Transpl. 6: S30-S34. http://www.ncbi.nlm.nih.gov/pubmed/11084082 Levy C, Lymp J, Angulo P, Gores GJ, LaRusso N, Lindor KD 2005 The value of serum CA 19-9 in predicting cholangiocarcinomas in patients with primary sclerosing cholangitis. Dig. Dis. Sci. 50: 1734-1740. http://www.ncbi.nlm.nih.gov/pubmed/16133981 2. When elevated CA 19-9 is detected, other methods must be used to confirm or rule out cholangiocarcinoma. Brush cytology and/or fluorescencce in situ hybridization (FISH) is often used: Furmanczyk PS, Grieco VS, Agoff SN 2005 Biliary brush cytology and the detection of cholangiocarcinoma in primary sclerosing cholangitis: evaluation of specific cytomorphologic features and CA19- 9 levels. Am. J. Clin. Pathol. 124: 355-360. http://www.ncbi.nlm.nih.gov/pubmed/16191503 Kipp BR, Stadheim LM, Halling SA, Pochron NL, Harmsen S, Nagorney DM, Sebo TJ, Therneau TM, Gores GJ, Groen PC, Baron TH, Levy MJ, Halling KC, LR 2004 A comparison of routine cytology and fluorescence in situ hybridization for the detection of malignant bile duct strictures. Am. J. Gastroenterol. 99: 1675-1681. http://www.ncbi.nlm.nih.gov/pubmed/16133981 3. A big problem in PSC is that elevated CA 19-9 can occur with dominant strictures, and in many patients CA 19-9 levels decrease following endoscopic intervention: sen-Benz C, Stiehl A 2005 Impact of dominant stenoses on the serum level of the tumor marker CA19-9 in patients with primary sclerosing cholangitis. Z. Gastroenterol. 43: 587-590. http://www.ncbi.nlm.nih.gov/pubmed/15986288 Bjornsson E, Kilander A, Olsson R 1999 CA 19-9 and CEA are unreliable markers for cholangiocarcinoma in patients with primary sclerosing cholangitis. Liver 19: 501-508. http://www.ncbi.nlm.nih.gov/pubmed/10661684 Sheen-Chen SM, Sun CK, Liu YW, Eng HL, Ko SF, Kuo CH 2007 Extremely elevated CA19-9 in acute cholangitis. Dig. Dis. Sci. 52: 3140-3142. http://www.ncbi.nlm.nih.gov/pubmed/17404889 4. The occurrence of this marker is not specific to cholangiocarcinoma, it can be elevated in other cancers. Uehara M, Manaka D, Baba S, Oji Y, Hirata K, Shimizu M, Noguchi M 2007 Prognostic study of preoperative serum levels of CEA and CA 19-9 in colorectal cancer. Gan To Kagaku Ryoho 34: 1413-1417. http://www.ncbi.nlm.nih.gov/pubmed/17876139 Has your husband's doctor expressed concern about his elevated CA 19- 9, and has any cytology (analysis of cells recovered from bile duct brushings during ERCP) been done to look for abnormalities? Best regards, Dave (father of (22); PSC 07/03; UC 08/03) > > My husband had a CA 19-9 test this week and the numbers are high. He's > had the test 3 times and they were all high. I would appreciate if > anyone would tell me what this all means? I have done some research > and know a little bit but I need more information. Here are the > numbers: 5/20/08 - 1473; 12/18/06 - 1475; 12/4/06 - 1774. > > Barbara (wife of (PSC 07, Panc surg 1/07, chronic panc, > gallbladder 7/06, HE, etc.) > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 2008 Report Share Posted May 21, 2008 Dear Barbara; You can find over 100 references on CA 19-9 here: http://www.psc-literature.org/CA19-9.htm I'll try to summarize some of the key points: 1. Some researchers use elevated CA 19-9 (> 100) as a potential marker for early detection of cholangiocarcinoma in PSC. Gores GJ 2000 Early detection and treatment of cholangiocarcinoma. Liver Transpl. 6: S30-S34. http://www.ncbi.nlm.nih.gov/pubmed/11084082 Levy C, Lymp J, Angulo P, Gores GJ, LaRusso N, Lindor KD 2005 The value of serum CA 19-9 in predicting cholangiocarcinomas in patients with primary sclerosing cholangitis. Dig. Dis. Sci. 50: 1734-1740. http://www.ncbi.nlm.nih.gov/pubmed/16133981 2. When elevated CA 19-9 is detected, other methods must be used to confirm or rule out cholangiocarcinoma. Brush cytology and/or fluorescencce in situ hybridization (FISH) is often used: Furmanczyk PS, Grieco VS, Agoff SN 2005 Biliary brush cytology and the detection of cholangiocarcinoma in primary sclerosing cholangitis: evaluation of specific cytomorphologic features and CA19- 9 levels. Am. J. Clin. Pathol. 124: 355-360. http://www.ncbi.nlm.nih.gov/pubmed/16191503 Kipp BR, Stadheim LM, Halling SA, Pochron NL, Harmsen S, Nagorney DM, Sebo TJ, Therneau TM, Gores GJ, Groen PC, Baron TH, Levy MJ, Halling KC, LR 2004 A comparison of routine cytology and fluorescence in situ hybridization for the detection of malignant bile duct strictures. Am. J. Gastroenterol. 99: 1675-1681. http://www.ncbi.nlm.nih.gov/pubmed/16133981 3. A big problem in PSC is that elevated CA 19-9 can occur with dominant strictures, and in many patients CA 19-9 levels decrease following endoscopic intervention: sen-Benz C, Stiehl A 2005 Impact of dominant stenoses on the serum level of the tumor marker CA19-9 in patients with primary sclerosing cholangitis. Z. Gastroenterol. 43: 587-590. http://www.ncbi.nlm.nih.gov/pubmed/15986288 Bjornsson E, Kilander A, Olsson R 1999 CA 19-9 and CEA are unreliable markers for cholangiocarcinoma in patients with primary sclerosing cholangitis. Liver 19: 501-508. http://www.ncbi.nlm.nih.gov/pubmed/10661684 Sheen-Chen SM, Sun CK, Liu YW, Eng HL, Ko SF, Kuo CH 2007 Extremely elevated CA19-9 in acute cholangitis. Dig. Dis. Sci. 52: 3140-3142. http://www.ncbi.nlm.nih.gov/pubmed/17404889 4. The occurrence of this marker is not specific to cholangiocarcinoma, it can be elevated in other cancers. Uehara M, Manaka D, Baba S, Oji Y, Hirata K, Shimizu M, Noguchi M 2007 Prognostic study of preoperative serum levels of CEA and CA 19-9 in colorectal cancer. Gan To Kagaku Ryoho 34: 1413-1417. http://www.ncbi.nlm.nih.gov/pubmed/17876139 Has your husband's doctor expressed concern about his elevated CA 19- 9, and has any cytology (analysis of cells recovered from bile duct brushings during ERCP) been done to look for abnormalities? Best regards, Dave (father of (22); PSC 07/03; UC 08/03) > > My husband had a CA 19-9 test this week and the numbers are high. He's > had the test 3 times and they were all high. I would appreciate if > anyone would tell me what this all means? I have done some research > and know a little bit but I need more information. Here are the > numbers: 5/20/08 - 1473; 12/18/06 - 1475; 12/4/06 - 1774. > > Barbara (wife of (PSC 07, Panc surg 1/07, chronic panc, > gallbladder 7/06, HE, etc.) > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 2008 Report Share Posted May 21, 2008 Dear Barbara; You can find over 100 references on CA 19-9 here: http://www.psc-literature.org/CA19-9.htm I'll try to summarize some of the key points: 1. Some researchers use elevated CA 19-9 (> 100) as a potential marker for early detection of cholangiocarcinoma in PSC. Gores GJ 2000 Early detection and treatment of cholangiocarcinoma. Liver Transpl. 6: S30-S34. http://www.ncbi.nlm.nih.gov/pubmed/11084082 Levy C, Lymp J, Angulo P, Gores GJ, LaRusso N, Lindor KD 2005 The value of serum CA 19-9 in predicting cholangiocarcinomas in patients with primary sclerosing cholangitis. Dig. Dis. Sci. 50: 1734-1740. http://www.ncbi.nlm.nih.gov/pubmed/16133981 2. When elevated CA 19-9 is detected, other methods must be used to confirm or rule out cholangiocarcinoma. Brush cytology and/or fluorescencce in situ hybridization (FISH) is often used: Furmanczyk PS, Grieco VS, Agoff SN 2005 Biliary brush cytology and the detection of cholangiocarcinoma in primary sclerosing cholangitis: evaluation of specific cytomorphologic features and CA19- 9 levels. Am. J. Clin. Pathol. 124: 355-360. http://www.ncbi.nlm.nih.gov/pubmed/16191503 Kipp BR, Stadheim LM, Halling SA, Pochron NL, Harmsen S, Nagorney DM, Sebo TJ, Therneau TM, Gores GJ, Groen PC, Baron TH, Levy MJ, Halling KC, LR 2004 A comparison of routine cytology and fluorescence in situ hybridization for the detection of malignant bile duct strictures. Am. J. Gastroenterol. 99: 1675-1681. http://www.ncbi.nlm.nih.gov/pubmed/16133981 3. A big problem in PSC is that elevated CA 19-9 can occur with dominant strictures, and in many patients CA 19-9 levels decrease following endoscopic intervention: sen-Benz C, Stiehl A 2005 Impact of dominant stenoses on the serum level of the tumor marker CA19-9 in patients with primary sclerosing cholangitis. Z. Gastroenterol. 43: 587-590. http://www.ncbi.nlm.nih.gov/pubmed/15986288 Bjornsson E, Kilander A, Olsson R 1999 CA 19-9 and CEA are unreliable markers for cholangiocarcinoma in patients with primary sclerosing cholangitis. Liver 19: 501-508. http://www.ncbi.nlm.nih.gov/pubmed/10661684 Sheen-Chen SM, Sun CK, Liu YW, Eng HL, Ko SF, Kuo CH 2007 Extremely elevated CA19-9 in acute cholangitis. Dig. Dis. Sci. 52: 3140-3142. http://www.ncbi.nlm.nih.gov/pubmed/17404889 4. The occurrence of this marker is not specific to cholangiocarcinoma, it can be elevated in other cancers. Uehara M, Manaka D, Baba S, Oji Y, Hirata K, Shimizu M, Noguchi M 2007 Prognostic study of preoperative serum levels of CEA and CA 19-9 in colorectal cancer. Gan To Kagaku Ryoho 34: 1413-1417. http://www.ncbi.nlm.nih.gov/pubmed/17876139 Has your husband's doctor expressed concern about his elevated CA 19- 9, and has any cytology (analysis of cells recovered from bile duct brushings during ERCP) been done to look for abnormalities? Best regards, Dave (father of (22); PSC 07/03; UC 08/03) > > My husband had a CA 19-9 test this week and the numbers are high. He's > had the test 3 times and they were all high. I would appreciate if > anyone would tell me what this all means? I have done some research > and know a little bit but I need more information. Here are the > numbers: 5/20/08 - 1473; 12/18/06 - 1475; 12/4/06 - 1774. > > Barbara (wife of (PSC 07, Panc surg 1/07, chronic panc, > gallbladder 7/06, HE, etc.) > Quote Link to comment Share on other sites More sharing options...
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