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Changes in the CA 19‐9 antigen and lewis blood group with pulmonary disease severity in cystic fibrosis
Author(s) -
Kane Robert E.,
Penny June,
Walker Kay,
Rubin Bruce K.,
Wu James
Publication year - 1992
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950120405
Subject(s) - medicine , gastroenterology , sputum , cystic fibrosis , asymptomatic , bronchiectasis , respiratory disease , carcinoembryonic antigen , lung , antigen , immunology , pathology , cancer , tuberculosis
The altered carbohydrate structure of sputum from patients with cystic fibrosis (CF) has been thought to be due to the inflammatory airway response. Carcinoembryonic antigen (CEA) and CA 19‐9 detect sialosylated carbohydrates in mucus. The epitope of CA 19‐9 is part of the Lewis A (Le a ) blood group antigen. Serum concentrations of CEA and CA 19‐9 were determined by radioimmunoassay in 41 CF patients, aged 6–34 years; 16 were asymptomatic Outpatients, and 25 had been admitted for pulmonary exacerbations. There was no difference in CEA between groups. The CA 19‐9 serum concentration was elevated in 90% of patients who had at least one of the two Lewis antigens. The CA 19‐9 concentration of Inpatients with exacerbations was 2.7 times that of stable Outpatients (263 ± 44 versus 99 ± 13 U/mL P < 0.02). CA 19‐9 correlated significantly with age (r = 0.35, P < 0.05), Brasfield score (r = 0.39, P < 0.015), pulmonary function tests, cough severity (r = 0.50, P < 0.001) and NIH clinical score (r = 0.57, P < 0.001). CA 19‐9 concentration of Inpatients decreased by 44% from admission to discharge (302 ± 45 to 169 ± 39, P < 0.02). Fourteen of 25 (56%) of the Inpatients were Le a positive versus only 3/15 (20%) of Outpatients who had milder lung disease ( P < 0.002). Of the Inpatients, 25% with more advanced lung disease were Le (a+b+), a rare blood group in the normal population, and one not observed in the Outpatients with milder disease. The results suggested that the serum CA 19‐9 concentration is an index of pulmonary disease severity in 94–95% of patients with CF who express the Lewis antigens, and it can be used to monitor response to therapy.