Dilemma of elevated CA 19-9 in biliary pathology

Adrianne Tsen, Mary Barbara, Laura Rosenkranz

Research output: Contribution to journalReview articlepeer-review

52 Scopus citations


Carbohydrate antigen 19-9 (CA 19-9) is a tumor marker which has been extensively evaluated and widely utilized primarily in diagnosing and prognosticating pancreaticobiliary malignancies. Levels may be significantly influenced and elevated in cases of benign biliary conditions however, especially in obstructive jaundice, thereby posing difficulty in distinguishing between benign and malignant cholestasis. A myriad of studies have focused on elucidating proper use and interpretation of CA 19-9 in pancreatic cancer as well as in the setting of cholestasis. These studies have demonstrated that many factors influence CA 19-9 values and various methods for interpreting CA 19-9 in obstructive jaundice have been proposed. With improvements in diagnostic imaging, advancements in endoscopic modalities, and likelihood that management will not change based on the results of the test, clinicians should be cautious when ordering CA 19-9 and consider the reasons for measuring the tumor marker.

Original languageEnglish (US)
Pages (from-to)862-867
Number of pages6
Issue number8
StatePublished - Dec 2018


  • Benign
  • Biliary
  • CA 19-9
  • Carbohydrate antigen 19-9
  • Malignant

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Hepatology


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