原 著 30 22-29, 2015 CA19-9 CA19-9 CA19-9 2006 12013 6 CA19-9 32,508 37.0U/mL 790 2 CA19-9 320 CA19-9 ARCHITECT i 2000SRCLIA 0.0 37.0U/mL 8 4 1 2 18CA19-9 198.2 46.4 2,968 U/mL 5 3 2.5% CA19-9 2.5% CA19-9 CA19-9 microrna CA19-9 1 1 2 3 0.5 0.8% 1% 80% 80% CEA 4% 1 CA19-9 CA19-9 2006 1 2013 6 7 6CA19-9 32,508 790 135-8550 3 8 31 Tel 03-3570-0503 Fax 03-3570-0504 22 ( 22 ) Vol.30 No.1 2015
5 55 20 35 2 CA19-9 320 104 216 56.0 CA19-9 CA19-9 CA19-9 2014 8CA19-9 1 CA19-9 ARCHITECT i 2000SR CLIA0.0 37.0U/mL CA19-9 6 12.4% CA19-9320 12 4 1 CA19-9 1 CA19-9 320 312 8 U/mL n=320 104 216 84.6 ± 198.0 49.5 55.8 ± 12.6 57.0 6.9 ± 6.3 5.0 37.1 2967.9 20 82 2 50 (n=312 100 212 75.7 ± 116.1 49.5 55.4 ± 12.6 56.0 6.9 ± 6.4 5.0 37.1 1559.6 20 82 2 50 n=8 4 4 431.0 ± 959.2 72.0 68.9 ± 5.7 68.5 4.8 ± 4.4 3.0 38.5 2967.9 59 78 2 16 Vol.30 No.1 2015 23 ( 23 )
2 312 3 312 CA19-9 4 312 CA19-9 31220 82 56.0 8 59 78 68.5 64 78 68.5 312 2 4 CA19-9 CA19-9 75.7 49.5 U/mL 100U/ ml87.5 42.8 36.5 6.95.0 3 126 312 CA19-9 5 6 312184CA19-9 128 CA19-9 CA19-9 37 4 20 22 34 54 15 101 5 10 18 361 3 24 ( 24 ) Vol.30 No.1 2015
5 100 CA19-9 6 212 CA19-9 IPMN Intraductal Papillary Mucinous Neoplasm 7 8 8CA19-9 2 7 CA19-9 46.4 2968.0 198.2 U/mL 4 1 2 13 PET-CT 2 CT 2 18 CA19-9 3 35 279.9 2390.4U/mL CT 1 4 CA19-9100U/mL 4,5 3 100U/mL 3 CA19-9 2CA19-9 8 91 2 68 CA19-9 1 95.1U/mL CA19-9 260.0U/mL 3 Vol.30 No.1 2015 25 ( 25 )
2 8 Stage 1 U/mL CA19-9 (U/mL CA19-9 U/mL 1 68 69.3 US (31M 2 b 16.8 69 117.0 US 19M 3 64 46.4 PET-CT 31M 4 6.9 78 74.7 US CT MRCP 57M 5 b 18.6 75 2968.0 US CT 12M 6 18.3 72 95.1 74 2390.4 3 4M 7 10.3 66 38.5 68 279.9 US CT2 US2PET-CT 20M 8 59 39.9 65 1703.3 US MRCP Magnetic Resonance Cholangiopancreatography 8 6 CA19-9 100U/mL 1 6 150.0U/mL 6 822.0U/mL 2,390.0U/ ml 18 1 2 7 9 CA19-9 10.3U/ ml 38.5U/mL 20 PET-CT CT 1 CA19-9 17.7U/mL 6 279.9U/mL CT 16mm 9 6 CA19-9 1 7 26 ( 26 ) Vol.30 No.1 2015
CA19-9 2.58/320 1.254/320 CA19-9 CA19-9 CA19-9 CA19-9 2.5 1.25 6 CA19-9 1CA19-9 4.110 42 1 Kim 7 CA19-9 0.9 Chang 8 0.5CA19-9 3.4 Kim 9 CA19-91,540 CT123 8% 15 CT CA19-94% 8 7Stage4 CA19-9 24 52 CA19-9 4 CT MRCP Magnetic Resonance CholangiopancreatographyERCP Endoscopic Retrograde Cholangiopancreatography 4 9 5Stage b Stage 7.8 10 1 27 CA19-9 25 8 CA19-9 CT CA19-9 4 CA19-9 Vol.30 No.1 2015 27 ( 27 )
CA19-9 CA19-9 11 CA19-9 100U/ ml 4,5 312 87.5 100U/mL 3 3/8=37.5 100U/mL 100U/mL 2 6 7 2 6 CA19-9 6 Stage 7 Stage 6 6 CA19-9 7 CA19-9 PET- CT CT CA19-9 CA19-9 12 Stage0 Pianteino 13 CA19-9 CA19-9 retrospective CA19-9 CA19-9 4 10% A Le a-b-ca19-9 2Le a+b-ca19-9 14 CA19-9 32,508 Le a+b- 6,500 CA19-9 780 2.4 Le a+b- CA19-9 CA19-9 145 145 3.45 /145 2.5 CA19-9 2 3CA19-9 2.5% CA19-9 CA19-9 CA19-9 microrna 15 55 2014 28 ( 28 ) Vol.30 No.1 2015
1 1 12. JSLM2012 / / 2012 58-62 2 38 2015 426 3 2009 5-6 4 2004 31 1443-1446. 5 Patel AH, Harnois DM, Klee GG, et al: The utility of CA 19-9 in the diagnoses of cholangiocarcinoma in patients without primary sclerosing cholangitis. Am J Gastroenterol 2000; 95: 204-207. 6 CA19-9 2014 29 610-615. 7 Kim JE, Lee KT, Lee JK, et al: Clinical usefulness of carbohydrate antigen 19-9 as a screening test for pancreatic cancer in an asymptomatic population. J Gastroenterol Hepatol 2004; 19: 182-186. 8 Chang CY, Huang SP, Chiu HM, et al: Low efficacy of serum levels of CA 19-9 in prediction of malignant diseases in asymptomatic population in Taiwan. Hepatogastroenterology 2006; 53: 1-4. 9 Kim JY, Kim SH, Kim SY: Elevated serum CA 19-9 at screening tests: underlying conditions and role of abdominopelvic CT. Eur Radiol 2014 ; 24: 2435-2448. 102007 2008 23 105-123 11 1994 27 743-752. 12 1 2012 8 123. 13 Piantino P, Andriulli A, Gindro T, et al: CA 19-9 assay in differential diagnosis of pancreatic carcinoma from inflammatory pancreatic diseases. Am J Gastroenterol 1986; 81: 436-439. 14 Narimatsu H, Iwasaki H, Nakayama F, et al: Lewis and secretor gene dosages affect CA 19-9 and DU-PAN- 2 serum levels in normal individuals and colorectal cancer patients. Cancer Res 1998; 58: 512-518. 15 Wang WS, Liu LX, Li GP, et al: Combined serum CA19-9 and mir-27a-3p in peripheral blood mononuclear cells to diagnose pancreatic cancer. Cancer Prev Res (Phila) 2013; 6: 331-338. 2015.1.26 2015.4.1 Evaluation of Elevated Serum CA19-9 Levels at Cancer Screening Center Tomoko Suzuki, Mizuka Imai, Motoko Kubota, Yoshiaki Kita, Tomohiro Tsuchida Cancer Screening Center of the Cancer Institute Hospital Abstract Objective: Generally, cancer screening using only tumor markers is considered insufficient because cancer often goes undetected in the early stage, and they sometimes produce falsepositive results. The aim of this study was to evaluate the positive predictive value (PPV) of serum CA19-9 and perform analysis on patients with high CA19-9 levels. Methods: Of the 32,508 patients whose serum CA19-9 was first measured from January 2006 to June 2013 in our center, 790 patients (0.024%) had high levels (> 37.0 U/mL). The subjects of our analysis were 320 patients among them whose serum CA19-9 was measured twice or more after the first measurement. Results: Among the eight patients diagnosed with cancer, 4 had pancreatic cancer, 2 had duodenal cancer, 1 cystic duct carcinoma and 1 colon cancer. The median serum CA19-9 level of the 8 patients was 198.2 U/mL (Range 46.4 2,968 U/mL). The positive predictive value (PPV) was 2.5%. Conclusion: Since the PPV of CA19-9 was only 2.5%, further examination of all patients with high levels may not be cost-effective. The use of the novel cancer detection method using organ-specific microrna in combination with conventional tumor markers may be promising. Keywords: CA19-9, positive predictive value (PPV), cancer Vol.30 No.1 2015 29 ( 29 )