Correlation between Jaundice and CA 19–9 Serum Levels in Benign and Malignant Conditions

Introduction: The study was aimed at evaluating the relation between CA 19–9 level and obstructive jaundice. Methods: Data from 88 patients referred for obstructive jaundice were analyzed. Results: A primary malignancy was diagnosed in 62 patients (MG) while a benign disease in 26 (BG). Although, elevated CA 19–9 levels were found in a part of BG (61.5%) the median value was significantly lower (173.2 vs. 2,709.9 U/ml). In the MG the normalization of CA 19–9 was mainly related to radical resection of the tumor, while a partial decrease was observed also after endoscopic stenting. In fact, 6 of the 15 malignant cases submitted to endoscopic stenting demonstrated a significant decrease in CA 19–9 levels (average 50.3%). Otherwise, in BG resolution of the acute condition lead to normalization of serum CA 19–9 that resulted to be strictly related to the corresponding variation of bilirubin concentration. Discussion: In presence of obstructive jaundice, distinguish between benign and malignant disease processes on the basis of elevated CA 19–9 is not reliable. However, the increase in CA 19–9 in BG is usually lower and relief of jaundice was constantly associated with a normalization of serum CA 19–9. A rising level in the absence of further jaundice is suggestive of an underlying malignancy, although a falling value does not exclude the diagnosis.