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CA 19-9
MessagePerforming Lab: Central Lab
Test Code
0934
Alias/See Also
Sunquest: CA199; Cancer Antigen 19-9, Carbohydrate Ag 19-9, CA 19-9
CPT Codes
86301
Preferred Specimen
0.3 mL Serum Separator (gold-top) tube
Minimum Volume
0.2 mL
Other Acceptable Specimens
Red, Red/Gray
Instructions
Processing: Centrifuge specimens within 2 hours of collection, aliquot and freeze
Transport Temperature
Refrigerated
Specimen Stability
Refrigerated: 2 days
Frozen: 4 weeks
Frozen: 4 weeks
Methodology
Chemiluminescence
Setup Schedule
Monday, Wednesday and Thursday
Report Available
Same day.
Limitations
The Access GI Monitor assay should not be used as a cancer screening test. Serum or plasma CA 19-9 antigen concentrations should not be interpreted as absolute evidence for the presence or absence of cancer. Elevated concentrations may be observed in the serum of patients with benign conditions or other non-cancer disorders, as well as in pancreatic cancer and other malignant diseases. The Access GI Monitor results should be interpreted in light of the total clinical presentation of the patient, including: symptoms, clinical history, data from additional tests, and other appropriate information.
Patients must possess the ability to express the Lewis blood group antigen or they will be unable to produce the CA 19-9 antigen even in the presence of proven malignancy. A patient with a positive genotype for the Lewis antigen may produce varying levels of CA 19-9 antigen. Phenotyping for the presence of the Lewis blood group antigen may be insufficient to detect true Lewis antigen negative individuals.
Patients must possess the ability to express the Lewis blood group antigen or they will be unable to produce the CA 19-9 antigen even in the presence of proven malignancy. A patient with a positive genotype for the Lewis antigen may produce varying levels of CA 19-9 antigen. Phenotyping for the presence of the Lewis blood group antigen may be insufficient to detect true Lewis antigen negative individuals.
Reference Range
0 - 35 U/mL
Clinical Significance
The CA 19-9 antigen, a Lewis blood group-related mucin, is a tumor-associated antigen synthesized by normal human pancreatic and biliary ductular cells, and gastric, colonic, endometrial and salivary epithelia. Typically, only a minimal amount of the CA 19-9 antigen is present in the blood of normal subjects or subjects with benign disorders. Most patients with carcinoma of the pancreas, however, have elevated levels of blood CA 19-9 antigen.
Initially found in colorectal cancer patients, the CA 19-9 antigen has also been identified in patients with pancreatic, bile duct, hepatocellular, stomach, and esophageal cancers. Non-cancerous conditions that may elevate CA 19-9 antigen levels include cirrhosis, cholangitis, hepatitis, pancreatitis, and nonmalignant gastrointestinal diseases.
CA 19-9 antigen levels may be used as an aid in monitoring the response to therapy for patients with pancreatic cancer. In pancreatic cancer patients, high levels of CA 19-9 antigen tend to be associated with more advanced disease. The presence of persistently rising CA 19-9 antigen levels may be correlated with disease progression. Persistently elevated CA 19-9 antigen levels may indicate poor response to therapy, whereas decreasing CA 19-9 antigen levels may indicate a positive therapeutic response.
Initially found in colorectal cancer patients, the CA 19-9 antigen has also been identified in patients with pancreatic, bile duct, hepatocellular, stomach, and esophageal cancers. Non-cancerous conditions that may elevate CA 19-9 antigen levels include cirrhosis, cholangitis, hepatitis, pancreatitis, and nonmalignant gastrointestinal diseases.
CA 19-9 antigen levels may be used as an aid in monitoring the response to therapy for patients with pancreatic cancer. In pancreatic cancer patients, high levels of CA 19-9 antigen tend to be associated with more advanced disease. The presence of persistently rising CA 19-9 antigen levels may be correlated with disease progression. Persistently elevated CA 19-9 antigen levels may indicate poor response to therapy, whereas decreasing CA 19-9 antigen levels may indicate a positive therapeutic response.
