Title: Raised serum CEA and CA 19-9 in Lung Cancer in tertiary care hospital in Eastern India
Authors: Ramesh Kumar Sahu, Sanjay Kothari, Pradeep Kumar Agarwal, Vineet Kumar Khemka, Subrata Das, Ravela Malathi
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.217
Abstract
Background: Lung cancer is the leading cause of cancer death worldwide. Unfortunately, most lung cancers are already unresectable and metastatic at initial diagnosis. Measurement of tumor markers is a non-invasive means to predict prognosis, and is therefore used in daily clinical practice.
Aims & Objectives: The aim of this study was to assess the diagnostic yield of the tumour markers carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9, in serum and bronchoalveolar lavage fluid in a group of patients with bronchogenic carcinoma.
Materials and Methods: Serum and bronchoalveolar lavage fluid samples were collected in a group of 38 cases with benign or malignant pulmonary diseases and 36 controls. The serum from all the subjects were analyzed for estimation of levels of various tumour markers like CEA and CA 19-9 using enzyme linked immunosorbant assay (ELISA) kits.
Results: Serum CEA level was found significantly higher among lung cancer subjects with respect to controls (28.15 ± 8.11 versus 5.82 ± 2.66 µg/L; P < 0.001). Moreover, serum CA 19-9 levels were elevated in lung cancer cases as compared to controls and were statistically significant (60.08 ± 17.14 versus 23.75 ± 10.58 U/ml; P < 0.001). Serum CEA level does not have any correlation with serum CA 19-9 (r = 0.175; P=0.322) level among lung cancer subjects as well as in controls (r = 0.075; P = 0.670).
Conclusion: Carcinoembryonic antigen was the most relevant marker in bronchoalveolar lavage fluid. For the factors evaluated in this study, determination of carcinoembryonic antigen and carbohydrate antigen 19-9 in bronchoalveolar lavage fluid were clinically more useful markers in comparison with serum, although the latter may also be helpful in certain situations. Although there is no specific tumour marker for lung cancer, the combination of several can be used to diagnose most patients with lung cancer and also to rule out false positive and negative cases.
Keywords: Tumour markers, CEA, CA 19-9, Lung carcinoma, Bronchoalveolar lavage fluid, Serum, ELISA.
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