Document Detail

Serum CA 19-9 levels as a diagnostic marker in cystic fibrosis patients with borderline sweat tests.
MedLine Citation:
PMID:  14598187     Owner:  NLM     Status:  MEDLINE    
Patients with normal or borderline sweat tests present a diagnostic challenge. In spite of the availability of genetic analysis and measurement of nasal potential difference, there is still uncertainty in diagnosing cystic fibrosis in some patients. CA 19-9 is a tumor-associated antigen whose levels were previously found to be elevated in some cystic fibrosis patients. We investigated whether serum CA 19-9 levels can contribute to establishing the diagnosis of cystic fibrosis in patients with a borderline sweat test, and evaluated the influence of different clinical variables on CA 19-9 levels. Serum CA 19-9 levels were measured in 82 cystic fibrosis patients grouped according to their genotype and in 38 healthy individuals. Group A included 50 patients who carried two mutations previously found to be associated with a pathological sweat test and pancreatic insufficiency (DeltaF508, W1282X, G542X, N1303K, and S549R). Group B included 13 compound heterozygote cystic fibrosis patients who carried one mutation known to cause mild disease with a borderline or normal sweat test and pancreatic sufficiency (3849+10kb C-->T, 5T). Group C included 38 normal controls. Nineteen cystic fibrosis patients carried at least one unidentified mutation. An association between CA 19-9 levels and age, pulmonary function, pancreatic status, sweat chloride, previous pancreatitis, serum lipase, meconium ileus, distal intestinal obstruction, liver disease, and diabetes was investigated. The distribution of CA 19-9 levels was significantly different between the three groups ( p<0.01); high CA 19-9 levels were found in 60% (30/50) of group Apatients and in 46.6% (6/13) of group B patients, but in only 5.2% (2/38) of the controls. CA 19-9 levels were inversely related to forced expiratory volume in 1 s, while no association was found with the other clinical parameters examined. Our findings suggest that the serum CA 19-9 in cystic fibrosis patients originates in the respiratory system, and has a useful ancillary role, particularly when diagnostic uncertainty exists. Hence, the diagnosis of cystic fibrosis should be considered in patients with borderline sweat tests and high CA 19-9 levels, but normal levels do not exclude cystic fibrosis.
A Augarten; H Berman; M Aviram; A Diver-Habber; H Akons; L Ben Tur; H Blau; E Kerem; J Rivlin; D Katznelson; A Szeinberg; B-S Kerem; L Theodor; G Paret; Y Yahav
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical and experimental medicine     Volume:  3     ISSN:  1591-8890     ISO Abbreviation:  Clin. Exp. Med.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-11-04     Completed Date:  2003-12-11     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  100973405     Medline TA:  Clin Exp Med     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  119-23     Citation Subset:  IM    
National Cystic Fibrosis Center, The Chaim Sheba Medical Center, Tel-Hashomer, Israel 52621.
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MeSH Terms
CA-19-9 Antigen / blood*
Cystic Fibrosis / blood,  diagnosis*
Cystic Fibrosis Transmembrane Conductance Regulator / genetics,  physiology
Electrolytes / analysis*
Sweat / chemistry*
Reg. No./Substance:
0/CA-19-9 Antigen; 0/CFTR protein, human; 0/Electrolytes; 126880-72-6/Cystic Fibrosis Transmembrane Conductance Regulator

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