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Significance of CA19-9 in Predicting the Prognosis of Urothelial Carcinoma: A Hospital Based Study from Nepal

  • Jha, Dipendra Kumar (Department of Biochemistry, Nepalese Army Institute of Health Sciences) ;
  • Mittal, Ankush (Department of Biochemistry, Nepalese Army Institute of Health Sciences) ;
  • Gupta, Satrudhan Pd (Department of Biochemistry, Nepalese Army Institute of Health Sciences) ;
  • Sathian, Brijesh (Department of Community Medicine, Manipal College of Medical Sciences)
  • Published : 2013.07.30

Abstract

Background: The present study was undertaken to establish any correlation of elevated levels of CA19-9 with tumor stage or grade of urothelial carcinoma. Materials and Methods: This hospital based study was carried out in the Department of Biochemistry of Nepalese Army Institute of Health Sciences between $1^{st}$ July 2012 and $31^{st}$ December 2012. Approval for the study was obtained from the institutional research ethical committee. CA19-9 was assayed with an ELISA reader for all cases and expressed in U/ml with 37U/ml taken as the cut-off upper value for normal. Results: Out of 20 cases enrolled, 15 were of urothelial carcinoma and the remaining 5 were controls. There was marked difference between the mean values of CA19-9 in cases $40.2{\pm}19.3U/ml$ of urothelial carcinoma and controls $7.98{\pm}7.34U/ml$. The number of cases in Ta, TI, T2, T3, T4 stages of urothelial carcinoma were 2, 6, 3, 3, 1 respectively. The percentage rise in CA19-9 was less with low grade tumors (22.2%) when compared with high grade tumors (66.6%) (p value $0.001^*$). The percentage of rise in CA19-9 for muscle invasive tumors was very high when compared to superficial tumors. Similarly, the percentage of rise in CA19-9 for metastatic disease was very high when compared to non-metastatic disease and it was found statistically significant (p value $0.001^*$). Conclusion: Serum CA19-9 levels predicts the prognosis of urothelial carcinoma as it is almost invariably raised in tumors having metastatic spread.

Keywords

CA 19-9;urothelial carcinoma;prognosis;Nepal

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