Guest guest Posted January 19, 2003 Report Share Posted January 19, 2003 ASCO has a summary of CA 19-9 here http://www.asco.org/asco/ascoMainConstructor/1,1003,_18-0011475-00_20- 006-00_19-0011495-00_12-002032,00.asp?state= (have to COPY link into browser, Yahoo splits long links) BOTTOM LINE: " CA 19-9 and CEA in combination did not improve the performance of the CEA test used alone " [snip] Indicator of asymptomatic recurrence. Only a few studies have addressed the use of CA 19-9 in monitoring patients post-primary therapy.102-104 Significant postsurgical decreases are observed for CA 19-9, but these decreases have not been correlated with survival or disease-free interval.102 Filella et al103 have reported their experience with CA 19-9 in monitoring disease recurrence. In 370 patients with colorectal cancer, progressive increases of serum CA 19- 9 were observed in 48% of 96 patients with relapse. However, the CA 19-9 abnormality preceded clinical manifestation of the disease in only 25% of the cases and provided a median lead time of only 3 months. CEA was abnormal in 84% of the relapsed cases and preceded clinical detection of recurrence in 75%. CA 19-9 and CEA in combination did not improve the performance of the CEA test used alone.103 The question you always have to ask with any test is, what are you going to DO if the test comes out positive? If CEA is up then you go on to get scans to check for possible tumors which can be resected. If tumors show on scans, they offer surgery or chemo based on what is seen. So there is a PURPOSE to CEA...as a motivator for further scans. There is a PURPOSE for scans - to determine further treatment. Treatment is never started based on CEA alone. CEA alone has no meaning. So what do you do if CA 19-9 is up? I'm sure they would not start any new treatment for this if they won't for elevated CEA. If CA 19-9 is up and CEA is normal, would they do scans based on that (ask them!)? The ASCO article seems to indicate a high false positive rate [snip] The false-positive rate (> 37.0 U/mL) is 15% to 30% in patients with nonneoplastic diseases of the pancreas, liver, and biliary tract.100,101 Consequently, CA 19-9 cannot be used for screening asymptomatic populations So this indicator seems maybe even worse than CEA (which is bad enough!) Best, Quote Link to comment Share on other sites More sharing options...
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