Stable CA-199 Levels: What It Means for Your Health

Regarding the CA 19-9 levels showing no change after multiple tests?

Hello Dr.
Hu, I would like to ask you a question.
I undergo an abdominal ultrasound every six months, and I have a routine colonoscopy and gastroscopy once a year, along with tumor marker screenings.
Recently, I reviewed my past examination reports and noticed that my CA 19-9 levels have consistently been at 2, with no fluctuations, while other markers show slight variations.
I researched online and found that a value of 2 is the lowest in the range.
In this case, could I be one of the small percentage of individuals who lack the Lewis antigen gene? I would greatly appreciate your guidance.
Thank you.

Mr. Huang, 40~49 year old female. Ask Date: 2023/09/29

Dr. Hu Ziren reply Oncology

The normal range for CA 19-9 is 0-37.
A value within this normal range is considered normal, so it is advised not to worry too much.

Reply Date: 2023/09/29

More Info

Understanding your CA 19-9 levels is crucial for monitoring your health, especially if you are undergoing regular screenings for gastrointestinal issues. CA 19-9 is a tumor marker primarily associated with pancreatic cancer, but it can also be elevated in other conditions such as gallbladder cancer, bile duct cancer, and even some benign conditions like pancreatitis or liver disease.
Your consistent CA 19-9 level of 2 U/mL, which is at the lower end of the normal range, is generally considered a good sign. Normal values for CA 19-9 typically range from 0 to 37 U/mL, so your level is well within this range. The fact that it has remained stable over time suggests that there is no significant change in your health status regarding the conditions that CA 19-9 is used to monitor.
Regarding your question about the Lewis antigen, it is indeed true that some individuals lack the Lewis antigen, which can lead to consistently low levels of CA 19-9. The Lewis antigen is a carbohydrate structure that is present on the surface of red blood cells and is genetically determined. People who are Lewis-negative may not produce CA 19-9 even in the presence of conditions that typically elevate it. If you suspect that you might be Lewis-negative, it could be worthwhile to discuss this with your healthcare provider. They may suggest genetic testing to confirm your Lewis antigen status.

It's important to remember that while tumor markers like CA 19-9 can provide valuable information, they are not definitive on their own. They should be interpreted in conjunction with other diagnostic tests and clinical evaluations. Your regular screenings, including abdominal ultrasounds and endoscopies, are essential for a comprehensive assessment of your gastrointestinal health.
If you have other markers that fluctuate, it may be beneficial to discuss these with your physician as well. Fluctuations in other tumor markers or health indicators can provide additional context to your overall health picture.
In summary, a stable CA 19-9 level of 2 U/mL is generally reassuring, especially when coupled with regular monitoring and other health screenings. If you have concerns about your Lewis antigen status or any other health issues, it is always best to consult with your healthcare provider for personalized advice and further testing if necessary. Regular communication with your healthcare team is key to maintaining your health and addressing any potential issues early on.

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