The Clinical Implication of Serum CA19-9 in Patients with Pulmonary Interstitial Fibrosis_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

ZuoQiunan ,  LiXiaohui , ChenHong

Department of Geratic Respiratory Medicine, Sichuan Provincial People's Hospital, Chengdu, Sichuan, 610072, China;

Corresponding author：

LiXiaohui, Email: 364830137@qq.com

Keywords：

CA19-9; Diffusing lung capacity for carbon monoxide; Pulmonary fibrosis

DOI：

10.7507/1671-6205.2016008

Video：

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Objective To investigate the implication of serum CA19-9 in patients with pulmonary interstitial fibrosis (PF). Methods One PF patient was followed up for 5 years, and the levels of serum CA19-9, arterial oxygen pressure and changes of chest CT scanning were recorded and analyzed.Furthermore, another 24 PF patients with the level of serum CA19-9 exceeding the cut-off value (37 U/mL) and 30 healthy controls were recruited, and the pulmonary function was compared between the PF patients and the healthy controls. Results During the 5-year follow-up, the serum CA19-9 increased gradually from 53.45 U/mL to > 1200 U/mL with progressive reticulation of the lungs proven by the chest CT scanning, and the arterial oxygen pressure in rest without oxygen inhalation decreased from 54 mm Hg to 32 mm Hg.Compared to the healthy controls, the PF patients had significantly higher serum CA19-9 levels [73.8(38.1-1200.0) U/mL vs.6.9(2.0-19.1) U/mL, P < 0.01] and worse diffusion function [55.0(12.7-87.8) mL·min^-1·mm Hg^-1 vs. 90.4(82.0-134.0) mL·min^-1·mm Hg^-1, P < 0.05].There was a significantly negative relationship between the elevation of CA19-9 and diffusion function (r=-0.997, P < 0.01). Conclusion Serum CA19-9 may increase in PF patients, which may be an indicator for poor prognosis.

Citation： ZuoQiunan, LiXiaohui, ChenHong. The Clinical Implication of Serum CA19-9 in Patients with Pulmonary Interstitial Fibrosis. Chinese Journal of Respiratory and Critical Care Medicine, 2016, 15(1): 30-33. doi: 10.7507/1671-6205.2016008 Copy

1.	Ho JJ, Bi N, Yan PS, et al. Characterization of new pancreatic cancer-reactive monoclonal antibodies directed against purified mucin. Cancer Res, 1991, 51:372-380.
2.	Shimizu Y, Hamada T, Tanaka Y, et al. Colonization of CA19-9 and KL-6 to epithelial cells in dilated bronchioles in a patient with idiopathic pulmonary fibrosis complicated by diffuse alveolar damage. Respirology, 2002, 7:281-284.
3.	Mukae H, Hirota M, Kohno S, et al. Elevation of tumor associated carbohydrate antigens in patients with diffuse panbronchiolitis. Am Rev Respir Dis, 1993, 148:744-751.
4.	Atkinson BF, Ernst CS, Herlyn M, et al. Gastrointestinal cancer-associated antigen in immunoperoxidase assay. Cancer Res, 1982, 42:4820-4823.
5.	Obayashi Y, Fujita J, Nishiyama T, et al. Role of carbohydrate antigens sialyl Lewis (a) (CA19-9) in bronchoalveolar lavage in patients with pulmonary fibrosis. Respiration, 2000, 67:146-152.
6.	Jiro F, Yuka O, Ichiro Y, et al. Marked elevation of CA19-9 in a patient with idiopathic pulmonary fibrosis:CA19-9 as a bad prognostic factor. Respirology, 1998, 3:211-214.
7.	Ohwada A, Takahashi H, Nagaoka I, et al. Effect of cigarette smoke on the mRNA and protein expression of carcinoembryonic antigen (CEA), a possible chemoattractant for neutrophils in human bronchioloalveolar tissues. Thorax, 1995, 50:651-657.
8.	Totani Y, Demura Y, Ameshima S, et al. Serum CA19-9 levels reflect bronchioalveolar lavage fluid neutrophil levels in idiopathic pulmonary fibrosis. Respiration, 2001, 68:438.
9.	Gronowitz E, Pitkanen S, Kjellmer I, et al. Association between serum oncofetal antigens CA19-9 and CA125 and clinical status in patients with cystic fibrosis. Acta Paediatr, 2003, 92:1267-1271.
10.	Totani Y, Demura Y, Ameshima S, et al. Silicosis characterized by increasing serum CA 19-9 in parallel with progression of lung fibrosis. Nihon Kokyuki Gakkai Zasshi, 2000, 38:137-142.
11.	Kodama T, Satoh H, Ishikawa H, et al. Serum levels of CA19-9 in patients with nonmalignant respiratory diseases. J Clin Lab Anal, 2007, 21:103-106.

1. Ho JJ, Bi N, Yan PS, et al. Characterization of new pancreatic cancer-reactive monoclonal antibodies directed against purified mucin. Cancer Res, 1991, 51:372-380.
2. Shimizu Y, Hamada T, Tanaka Y, et al. Colonization of CA19-9 and KL-6 to epithelial cells in dilated bronchioles in a patient with idiopathic pulmonary fibrosis complicated by diffuse alveolar damage. Respirology, 2002, 7:281-284.
3. Mukae H, Hirota M, Kohno S, et al. Elevation of tumor associated carbohydrate antigens in patients with diffuse panbronchiolitis. Am Rev Respir Dis, 1993, 148:744-751.
4. Atkinson BF, Ernst CS, Herlyn M, et al. Gastrointestinal cancer-associated antigen in immunoperoxidase assay. Cancer Res, 1982, 42:4820-4823.
5. Obayashi Y, Fujita J, Nishiyama T, et al. Role of carbohydrate antigens sialyl Lewis (a) (CA19-9) in bronchoalveolar lavage in patients with pulmonary fibrosis. Respiration, 2000, 67:146-152.
6. Jiro F, Yuka O, Ichiro Y, et al. Marked elevation of CA19-9 in a patient with idiopathic pulmonary fibrosis:CA19-9 as a bad prognostic factor. Respirology, 1998, 3:211-214.
7. Ohwada A, Takahashi H, Nagaoka I, et al. Effect of cigarette smoke on the mRNA and protein expression of carcinoembryonic antigen (CEA), a possible chemoattractant for neutrophils in human bronchioloalveolar tissues. Thorax, 1995, 50:651-657.
8. Totani Y, Demura Y, Ameshima S, et al. Serum CA19-9 levels reflect bronchioalveolar lavage fluid neutrophil levels in idiopathic pulmonary fibrosis. Respiration, 2001, 68:438.
9. Gronowitz E, Pitkanen S, Kjellmer I, et al. Association between serum oncofetal antigens CA19-9 and CA125 and clinical status in patients with cystic fibrosis. Acta Paediatr, 2003, 92:1267-1271.
10. Totani Y, Demura Y, Ameshima S, et al. Silicosis characterized by increasing serum CA 19-9 in parallel with progression of lung fibrosis. Nihon Kokyuki Gakkai Zasshi, 2000, 38:137-142.
11. Kodama T, Satoh H, Ishikawa H, et al. Serum levels of CA19-9 in patients with nonmalignant respiratory diseases. J Clin Lab Anal, 2007, 21:103-106.

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The Clinical Implication of Serum CA19-9 in Patients with Pulmonary Interstitial Fibrosis

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