It is important to detect intestinal malignancy with Crohn's disease (CD) in early stage but it is difficult to find early cancer in inflamed mucosa or stenotic lesion in clinical practice. The elevation of tumor markers is usually seen in advanced cancer and not useful in surveillance. On the other hand, high level of CEA (carcinoembryonic antigen) or CA19-9 is not always seen in advanced cancer but sometimes found in CD patients without malignant disease. We aimed to analyze proportion and characteristics of patients with CD whose CEA or CA19-9 is elevated.Methods:
We reviewed medical record of 100 patients (male 58, female 42, mean age 41 ± 8.5) with CD in Tokyo Yamate Medical Center and investigated their level of CEA and CA19-9, duration of disease, smoking habit, type of disease and activity.Results:
High level of CEA (>5.0 ng/mL) or CA19-9 (>37 U/mL) are seen in 21% of the patients (CEA: 14, CA19-9: 5, both: 2). These patients tend to be older than those with normal markers (44 ± 12.8 versus 40 ± 8.5 yr), with longer duration of CD (20 ± 8.3 versus 17 ± 6.8 yr) and higher smoking rates (38.1% versus 20.3%). Twenty-four out of 100 patients were in active phase and their level of tumor markers was high in 12.5% whose disease has stenotic lesion. All of these patients with elevated markers were precisely examined or underwent surgery and ruled out any malignant disease. 66.7% of them (14 patients) had stenosis in small intestine or colon. Five patients had high level of CEA and one had high CA19-9 before surgery and their tumor markers were normalized after resection of stenotic lesion. CEA had been increased again in one patient under progression of active disease.Conclusions:
Elevated CEA or CA19-9 is seen in 21% of CD patients without malignancy and might associated with stenotic lesion.