Elevated CA19-9 - what does this mean?

I have had two bloods tests done in the last six months… the last one being end of April. Both results have come back with the usual elevated liver enzymes and also elevated CA19-9… This time a little higher than the last. 41 in November and 48 in April.

Now, from general reading I understand that this is a tumour marker that is primarily used for diagnosing and tracking pancreatic cancer but can also be an indicator of other cancers and problems. I am wondering if this can be indicative of cholangitis or some other lIver problem. Has anyone else come across this reading in their blood works? If so, what did the doc say?

I don’t have a great GP hence am trying to understand this better myself.

Hi Priya,

First of all, as a cancer marker CA19-9 is not accurate at all. Many doctors don't bother with it because of it's low specificity and sensitivity.

In addition, CA19-9 can also point to a blockage in your bile system. I twice had elevated CA19-9 (up to 137) and in both instances it went down after ERCP. In fact, if I remember well, my doctor recommended the ERCP because of the CA19-9.

My doctor says he doesn't worry about cancer below a CA19-9 value of 200. An internet friend of mine passed away after they found his CA19-9 to be 18000 (the three zeros are no mistake). In my experience (and I am not a doctor) your values are not yet a reason for worry.



Hi Priya

I had a CA19-9 of about 180 a couple of years back but this was due to an infection. It is now 15 and one that goes up and down is probably inflammatory or due to infection. A CA19-9 which has a general upward trend needs to be investigated. The numbers that I have been told are below 37 is normal and above 120 is significant. After my 180 reading I had 3 ERCPs and an MRCP but no malignancy was found. What is being done to investigate the increase?

Hi All
Thank you for your prompt responses. Admittedly due to the ‘low’ reading I wasn’t thinking the worst but wanted to understand what the reading may indicate instead. When I had an MRCP done in January it had identified a stricture in the common bile duct as well as an enlarged gallbladder. My hunch is that the blockage may be in relation to the CBD and causing further inflammation around the area which would explain the elevated liver enzymes and the mild itching I’ve been getting the past couple of weeks.
(weird how we end up becoming our own docs!)
As for what I am doing to investigate the increase… I waiting for my next hospital appointment in July. I did see my GP yesterday but he didn’t even know that I had PSC or what it was so there wasn’t much point taking that conversation any further.

Hi Priya,

CA19-9 is indeed used as a tumor marker. Similar to others that have responded I too have had this test as part of general surveilance for psc and liver related cancers. Mine too was also raised, can't remember the actual value, it was either 140 something or 240 something. The problem with this particular marker is that it is also known to be raised with liver disease, which of course we all have. So its a bit questionable as to how useful it is as a specific marker in our cases. Its therefore one of those things that seems to be used as part of an overall package of survelance techniques. My consultant didn't seem to be too concerned with the result, given all the other tests, so I didn't worry about it too much either.

Hope thats helpful.