KOLESİSTEKTOMİ SONRASI UZAMIŞ CA 19-9 YÜKSEKLİĞİ: OLGU SUNUMU
Karbonhidrat antijeni 19-9 gliko spingo lipid yapıda olup serum tümör belirteci olarak bilinir. CA19-9pankreatik, bilier, hepatosellüler ve gastrointestinal sistem kanserlerinde kullanılan bir tümör belirleyiciolmasına rağmen pankreatit ve kolanjit, kolesistit, koledokolitiazis gibi benign safra kanalı hastalıklarında dayüksek olabilmektedir. Biz bu olgu sunumunda kolesistektomi sonrası uzun süren yükselmiş CA 19-9 seviyesiolan vakayı sunuyoruz. Bu vaka 41 yaşında olup kronik kolesistit nedeniyle laparoskopik kolesistektomioperasyonu yapılan ve yükselmiş CA 19-9 düzeyi saptanan bir hastaydı. Operasyon sonrası CA 19-9 seviyesi2169 U/mL seviyesine kadar yükselmiş olup, operasyon sonrası 5. ayda normale döndü. Kolesistektomi sonrasıuzun süren CA19-9 seviyesi yüksekliği akılda tutulmalıdır
Prolonged High Levels of CA 19-9 After Cholecystectomy: A Case Report
Carbohydrate antigen 19-9 (CA 19-9), is a glycosphingolipid known as one of the serum tumor markers. Although CA 19-9 is a tumor marker which used in pancreatic, biliary, hepatocellular and gastrointestinal malignancies, high levels of CA19-9 have also been reported in pancreatitis and benign biliary tract diseases as cholangitis, cholecystitis, choledocholithiasis. In this case report, we present a case with prolonged high levels of CA19-9 after cholecystectomy. Case was a 41 years-old patient who had laparascopic cholecystectomy operation due to chronic cholecystitis and high levels of CA 19-9. The levels of CA 19-9 increased up to 2169 U/mL and returned to normal levels five months after the operation. It should be considered that prolonged high levels ofCA 19-9 might occur after cholecystectomy.
___
- 1. Steinberg W. The clinical utility of the CA 19-9 tumorassociated
antigen.Am J Gastroenterol 1990;85:350-5.
- 2. Ayyıldız MO, Kızılay E, Müftüoğlu E. Tümör
markırları ve klinik kullanım alanları. T Klin Tıp
Bilimleri 1999;19:114-22.
- 3. Gülşen MT, Büyükberber M, Kis C, Kadayıfçı A,
Koruk M, Savaş MC. Yüksek CA 19-9 seviyeleri ile
seyreden bir benign biliyer darlık olgusu. Turkiye
Klinikleri J Gastroenterohepatol 2004;15:122-5
- 4. Şahin M, Cüre E, İşler M, Barut İ. Elevated CA 19-9
levels in patient with cholecystitis. Fırat Tıp Dergisi
2007;12(1):81-83.
- 5. Sheen-Chen SM, Sun CK, Liu YW, Eng HL, Ko SF,
Kuo CH. Extremely elevated CA 19-9 in acute
cholangitis. Dig Dis Sci 2007;52:3140-2.
- 6. Arends JW, Verstynen C, Bosman FT, Hilgers J,
Steplewski Z. Distribution of monoclonal antibodydefined
monosialoganglioside in normal and cancerous
human tissues: an immunoperoxidase study.
Hybridoma 1983;2(2):219-29.
- 7. Kim HJ, Kim MH, Myung SJ, Lim BC, Park ET, Yoo
KS, et al. A new strategy for the application of CA 19-9
in the differentiation of pancreatico-biliary cancer:
analysis using a receiver operating characteristic curve.
Am J Gastroenterol 1999;94:1941-6.
- 8. Ohshio G, Manabe T, Watanabe Y, Endo K, Kudo H,
Suzuki T, et al. Comparative studies of DU-PAN-2,
carcinoembryonic antigen, and CA 19-9 in the serum
and bile of patients with pancreatic and biliary tract
diseases: evaluation of the influence of obstructive
jaundice.Am J Gastroenterol 1990;85:1370-6.
- 9. Buccheri GF, Ferrigno D, Sartoris AM, Violante B,
Vola F, Curcio A, et al. Tumor markers in bronchogenic
carcinoma. Superiority of tissue polypeptide antigen to
carcinoembryonic antigen and carbohydrate antigenic
determinant 19-9. Cancer 1987;60:42-50.
- 10. YiğitbaşıR, Karabıçak İ,Aydoğan F, Ertürk S, Bican O,
Aydın O, et al. Benign splenic epithelial cyst
accompanied by elevated CA 19-9 level: a case report.
Mt Sinai J Med 2006;73(6):871-3.
- 11. Akdoğan M, Şaşmaz N, Kayhan B, Biyikoğlu I,
Dişibeyaz S, Sahin B. Extraordinarily elevated CA 19-
9 in benign conditions: a case report and review of the
literature. Tumori 2001;87:337-9.
- 12. Katsonos KH, Kitsanou M, Christodoulou DK, Tsianos
EV. High CA 19-9 levels in benign biliary tract diseases
report of four cases and review of the literature. Eur J
Intern Med 2002;13:132-135.
- 13. Lin CL, Changchien CS, Chen YS. Mirizzi's syndrome
with a high CA 19-9 level mimicking
cholangiocarcinoma. Am J Gastroenterol
1997;92:2309-10.
- 14. Milionis HJ, Elisaf MS, Tsianos EV. Postcholecystectomy
transient hundred-fold increase in CA
19-9. Eur J Gastroenterol Hepatol 1997;9(10):1013-4.
- 15. Albert MB, Steinberg WM, Henry JP. Elevated serum
levels of tumor marker CA 19-9 in acute cholangitis.
Dig Dis Sci 1988;33:1223-5.
- 16. Ker CG, Chen JS, Lee KT, Sheen PC, Wu CC.
Assessment of serum and bile levels of CA 19-9 and CA
125 in cholangitis and bile duct carcinoma. J
Gastroenterol Hepatol 1991;6:505-8.