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What Causes Elevated CA Levels?

Posted on Mon, 8 Sep 2014

Question: Hello Doctor -

I have received my blood work results today and I have

few concerns.

CA 19-9 - 38 reference range:0-35 U/mL)
Amylase, Serum - 100 (reference range: 31-124 U/L)
Lipase, Serum - 43 (reference range: 0-59 U/L)

The CA 19-9 value is HIGH and Amylase value is HIGH

Normal.

I am very worried about high value of CA 19-9 value .

Is it clinically significant? What I need to do next?

Thanks

Answered by Dr. dr. Jawahar Ticku (6 hours later)

Brief Answer:
Pancratic anomaly

Detailed Answer:
Dear XXXXX,
Thanks for asking for our opinion.
There is mild increase in Ca 19.9, other tests are within normal range. Mild pancreatitis can give rise to this condition.
To redress your concern it is better to have CT/ MRI with contrast of upper abdomen to rule out any change in pancreas. Further test like ERCP can be done if any anomaly is detected in your MRI.
Presently I feel simple conservative management should relieve you of your present trouble. Repeating CEA 19.9 after 4 to six weeks of conservative treatment, if there is marked rise, you need to undergo above investigations.
Presently I feel you should not be worried as you should feel improvement after symptomatic treatment.
truly,
Dr. J. Ticku

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. dr. Jawahar Ticku (43 hours later)

Hello Dr. Ticku -

Thanks for your time and expert advice.

I have seen gastroenterologist this week and he has schedule EUS/Endoscopic ultrasound next week.

1) How EUS is different from ERCP and which test is better?

2) What are the chances of having a tumor with slightly elevated CA19-9?

3) Are there any chances of having a tumor in other body parts (except pancreas)when CA19-9 elevated?

4) How accurate and sensitive CA19-9 test. Is it reliable for cancer screening?

5) If I may have mild pancreatitis, why the lipase and Amylase are normal and not elevated?

Sorry for many questions, but I'm concerned about abnormal CA-19-9 result and having many questions about my health.

Thanks you very much for your time and advice.

Best Regards

--XXXXX

Answered by Dr. dr. Jawahar Ticku (2 hours later)

Brief Answer:
pancreatic anomaly

Detailed Answer:
Dear XXXXX,
Thanks for the revert. EUS is radiological evaluation and Ercp is eye witness examination. Both are valuable at their own place. It depends on the situation which the the enterologist decides which will be better. In case the radological examination reveals some anomaly ERCP may be required to see the anomaly and take some tissue for the biopsy.
As I told you that you initially need radilological assessment and you may not need ERCP. Mild increase in Ca19.9 is insignificant and simple conservative treatment might get you complete relief.
truly,
Dr. J. Ticku

Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Prasad