The baseline pretreatment serum CA 19-9 level is measured in all patients with suspected pancreatic adenocarcinoma. In interpreting this level, it is important to bear in mind that it may be elevated in cases of other malignant conditions and mildly elevated in cases of certain benign conditions, such as pancreatitis. In addition, the serum CA 19-9 level is influenced by the presence of jaundice and the patient's Lewis blood-group phenotype. Because many patients undergo initial serum CA 19-9 evaluation soon after presentation with clinical jaundice, repeat evaluation should be performed after successful palliation of the jaundice. As with most tumor markers, the serum CA 19-9 level may optimally be used as supporting evidence in the clinical diagnosis and staging of pancreatic cancer, as a variable in the assessment of biochemical response to therapy, and for posttreatment follow-up evaluation in clinical trials.
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