Decrease in a markedly elevated CA19-9 level after stenting of a benign pancreatic ductal stricture

Blood Level of Glial Fibrillary Acidic Protein (GFAP) Does not Correlate With Disease Progression in a Rat Model of Familial ALS (SOD1G93A Transgenic)

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by specific loss of motor neurons in the spinal cord and brain stem. Currently, there are limited options for treating ALS and further investigation of the disease etiology and ALS disease progression need to be completed. There is an urgent need to identify biomarkers to detect and study disease progression in ALS. Glial fibrillary acidic protein (GFAP) is an intermediate filament protein that is expressed by a number of cells related to the central nervous system including glial cells and ependymal cells. Recent studies indicated that significant levels of GFAP protein were detected in peripheral tissues, such as skeletal muscle. In this study, we hypothesized that levels of GFAP in blood represent a biomarker of disease progression in ALS. To test this specific hypothesis, we used a rat model of familial ALS (SOD1^G93A transgenic), which has been extensively used to understand the complexity of this devastating disease. Disease progression in a cohort of male and female SOD1^G93A transgenic rats was monitored by motor function, and blood samples were collected when these animals reached disease end-stage. We measured GFAP protein levels by ELISA and found no correlation between GFAP concentration and disease progression in either serum and plasma samples of SOD1^G93A transgenic. Further investigation would be required in order to implicate blood GFAP as a potential biomarker for ALS.

Elevated serum CA19-9 levels in patients with common bile duct stones

AIM: To observe changes in serum carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) levels in patients with common bile duct stones.

METHODS: A total of 68 patients with surgically confirmed common bile duct stones were included in the study. The correlations of serum CEA and CA19-9 with total bilirubin and direct bilirubin were analyzed. For 20 patients whose serum CA19-9 levels were twice more than the upper limit of normal values, a consistent follow-up was conducted to analyze the correlations of the difference between preoperative and postoperative serum CA19-9 levels with total bilirubin and direct bilirubin.

RESULTS: Significant correlations were noted between serum CA19-9 and total bilirubin and direct bilirubin (r = 0.813 and 0.786, respectively; both P = 0.000) in patients with common bile duct stones. No significant correlations were noted between serum CEA and total bilirubin and direct bilirubin. The difference between preoperative and postoperative serum CA19-9 levels has significant correlations with total bilirubin and direct bilirubin (r = 0.787 and 0.806, respectively; both P = 0.000).

CONCLUSION: Elevated serum CA19-9 levels are noted in patients with concurrent common bile duct stones and obstructive jaundice. In these patients, serum CA19-9 as a tumor marker has a poor specificity.