Association of Carbohydrate Antigen 19-9 Elevation Among Patients With Alcohol-Related Liver Disease Undergoing Liver Transplant.

Objectives: Carbohydrate antigen 19-9 is a tumor marker with high sensitivity and specificity for pancreaticobiliary malignancies. However, an increase in carbohydrate antigen 19-9 has also been reported in non-neoplastic diseases and in some circumstances has been associated with environmental exposures. We evaluated the levels of carbohydrate antigen 19-9 in patients with alcohol-related liver disease and whether these levels differ in patients with recent alcohol use versus remote alcohol use.

Materials and methods: We evaluated a cohort of patients with alcohol-related liver disease undergoing liver transplant who presented with levels of carbohydrate antigen 19-9 in the absence of other pancreaticobiliary pathologies known to cause carbohydrate antigen 19-9 elevation.

Results: In our patients with a diagnosis of alcohol-related liver disease, carbohydrate antigen 19-9 levels were overall elevated beyond the upper limit of the reference range. Furthermore, these levels were significantly higher in patients with recent alcohol use versus remote alcohol use.

Conclusions: This elevation could be a result of biliary ductal epithelial cell inflammation caused by alcohol, subsequently causing increased secretion of carbohy-drate antigen 19-9. Carbohydrate antigen 19-9 levels should be interpreted with caution, and treatment should be individually tailored to address individual patient-specific situations.