n South African Journal of Surgery - The rise and fall of CA 19-9 : editorial




Tumour markers abound in the field of gastroenterology. One of the most ubiquitous is carbohydrate antigen 19-9 (CA 19-9), which was first described by Koprowski in 1979 as an abnormal glycoprotein, expressed on the surface of colorectal cell lines. Also referred to as sialyl Lewis-a CA 19-9, it is formed as a result of an aberrant pathway during production of its normal counterpart disialyl Lewis-a. The latter is a glycoprotein predominantly expressed in non-malignant epithelial cells. The abnormal form can be measured in serum by a specific monoclonal antibody. Ten per cent of the white population lack the Lewis blood group antigen and are unable to produce CA 19-9, even in the presence of malignant disease.


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