The change in serum Ca 19-9 levels according to treatment responses in pulmonary nontuberculous mycobacterial disease

Abstract

Purpose: CA 19-9 is a useful marker for the diagnosis of gastrointestinal cancer including pancreatic cancer. However, there are several previous studies about CA 19-9 elevation in benign lung diseases like emphysema, fibrosis and bronchiectasis. This study evaluates the clinical significance of serum CA 19-9 elevation in cases of pulmonary nontuberculous mycobacterial (PNTM) disease and cases of pulmonary tuberculosis (TB). Methods: Serum CA 19-9 levels in patients with PNTM (n=59) and pulmonary TB (n=36) were measured. Multivariate logistic regression analysis was performed to evaluate the factors related to CA 19-9 elevation in PNTM disease. The sequential changes in serum CA 19-9 before and after treatment were compared between pulmonary TB and PNTM disease. Results: The median CA 19-9 level was higher in patients with PNTM disease than in patients with pulmonary TB (PNTM: 13.80, TB: 5.85, P <0.001). Mycobacterium abscessus (OR 21.78, 95% CI: 1.68, 282.38; P =0.018) and extensive pulmonary lesions in more than three lobes (OR 11.03, 95% CI: 1.03, 117.89, P =0.047) were associated with elevated CA 19-9 levels in PNTM disease. CA 19-9 levels showed a tendency to decrease during successful treatment of PNTM disease but not in pulmonary TB. Conclusion: S erum CA 19-9 level was increased in substantial proportions of the patients with PNTM disease; in this setting, CA 19-9 may be a useful marker for monitoring therapeutic responses. Key words: Carbohydrate antigen 19-9; Nontuberculous mycobacteria; Tuberculosis; Biological marker Abbreviations : PNTM : Pulmonary nontuberculous mycobacterium TB : Tuberculosis CA 19-9 : Carbohydrate antigen 19-9.