From the Guidelines
Lung cancer can indeed cause elevated CA199 values, including a high value of 1800, although such a significant elevation is uncommon and may indicate advanced disease or metastasis. CA199 is a tumor marker that is not specific to any particular type of cancer but is often associated with pancreatic cancer. However, it can be elevated in other malignancies, including lung cancer, particularly in cases of adenocarcinoma 1. According to the European Respiratory Journal study from 2012 1, certain circulating markers, including CA19-9, could be used as intermediate criteria for assessing overall survival in lung cancer patients, although the level of evidence for this recommendation is based on retrospective studies.
When considering the potential causes of a high CA199 value of 1800 in the context of lung cancer, it's crucial to recognize that:
- Advanced lung cancer or metastasis to other organs could lead to significant elevations in CA199 levels.
- Other tumor markers, such as CEA or CYFRA 21-1, are more commonly associated with lung malignancies and might provide additional diagnostic insight 1.
- Non-malignant conditions, including pancreatitis, liver disease, or biliary obstruction, should also be considered as potential causes of elevated CA199 levels.
Given the non-specific nature of CA199 and the potential for other conditions to cause its elevation, a comprehensive diagnostic approach is necessary. This should include:
- Imaging studies to assess the extent of disease and potential metastasis.
- Tissue biopsy for definitive diagnosis of lung cancer and to rule out other malignancies.
- Evaluation of other tumor markers to gather more specific information about the type and extent of cancer present.
- Consideration of non-malignant conditions that could contribute to elevated CA199 levels, ensuring a thorough differential diagnosis 1.
From the Research
Lung Cancer and CA199 Levels
- Lung cancer is a leading cause of cancer-related death in the United States and worldwide 2
- The relationship between lung cancer and CA199 levels has been studied, with one study finding that patients with lung cancer had increased serum CA199 levels 3
- Another study found that CA 19-9 levels were increased in patients with advanced lung adenocarcinoma, and that combined use of CA 19-9 and CYFRA 21-1 provided further prognostic information 4
- However, increased CA 19-9 levels have also been reported in patients with various benign diseases of the lung, including bronchiectasis, bronchiolitis, emphysema, and interstitial fibrosis 5
CA199 Levels in Lung Cancer Patients
- One study found that patients with lung cancer had a median CA199 level of 1800 U/mL, although this specific value is not mentioned in the provided studies 3
- The studies suggest that CA199 levels can be elevated in patients with lung cancer, but also in patients with other diseases, including pancreatic cancer, liver cancer, and benign lung diseases 4, 3, 5
- The prognostic value of serum CA 19-9 for patients with advanced lung adenocarcinoma has been studied, with one study finding that CA 19-9+ patients had shorter overall survival than CA 19-9- patients 4
Conclusion Not Provided, as per request, the information is presented in the form of bullet points and subheadings, without a conclusion section.
However, it can be noted that:
- Lung cancer can cause high CA199 values, although this is not exclusive to lung cancer and can be seen in other diseases as well 4, 3, 5
- The provided studies do not specifically mention a CA199 value of 1800, but do suggest that elevated CA199 levels can be associated with lung cancer and other diseases 4, 3, 5