Skip to main content
Top
Published in: Journal of Cardiothoracic Surgery 1/2021

Open Access 01-12-2021 | Cancer Biomarker | Research article

Elevated tumor markers in a benign lung disease

Authors: Quan Chen, Qijue Lu, Xiang Fei, Chunguang Li, Bai Li

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

Login to get access

Abstract

Background

This study aimed to determine the underlying pathophysiologic mechanism of elevated carbohydrate antigen 19-9 (CA19-9) in pulmonary sequestration (PS) patients.

Materials and methods

Four pulmonary sequestration patients, 12 pneumonia patients and 12 healthy adult volunteers were prospectively studied. Specimens from another 34 pulmonary sequestration patients were retrospectively analyzed. Serum CA19-9 levels of 4 patients were tested before and 1 week, 1 month and 3 months after surgery. The CA19-9 levels of 12 pneumonia patients and 12 healthy adult volunteers were tested as controls. The expression and localization of CA19-9 in diseased lesions and corresponding normal lung tissues were analyzed by Immunohistochemical (IHC). Hematoxylin–eosin (HE) staining was performed to observe the pathological changes in pulmonary sequestration tissues.

Results

Serum CA19-9 levels were significantly higher in the 4 patients (797.3 ± 316 IU/ml) than in the pneumonia patients (10.07 ± 5.01 IU/ml) and healthy volunteers (9.85 ± 4.12 IU/ml). In addition, serum CA19-9 levels decreased dramatically after the focus was removed. Positive staining of CA19-9 was found in 70% (24/34) of pulmonary sequestration tissues, and CA19-9 was mainly expressed in the bronchial mucus. In the 4 diseased lesions, deformed alveolar structure and inflammatory cell infiltration were observed, and the degree of damage was positively correlated with serum CA19-9 levels.

Conclusions

CA19-9 could be generated by abnormal columnar epithelia in pulmonary sequestration tissues and was transported into circulation after alveoli damage. CA19-9 could serve as an adjuvant diagnostic marker in pulmonary sequestration.
Literature
1.
go back to reference Mathew S, Erozan YS. Pulmonary sequestration—a diagnostic pitfall: a case report. Diagn Cytopathol. 1997;16:353–7.CrossRef Mathew S, Erozan YS. Pulmonary sequestration—a diagnostic pitfall: a case report. Diagn Cytopathol. 1997;16:353–7.CrossRef
2.
go back to reference Abbey P, Das CJ, Pangtey GS, et al. Imaging in bronchopulmonary sequestration. J Med Imaging Radiat Oncol. 2009;53:22–31.CrossRef Abbey P, Das CJ, Pangtey GS, et al. Imaging in bronchopulmonary sequestration. J Med Imaging Radiat Oncol. 2009;53:22–31.CrossRef
3.
go back to reference Shanmugam G, MacArthur K, Pollock JC. Congenital lung malformations—antenatal and postnatal evaluation and management. Eur J Cardiothorac Surg. 2005;27:45–52.CrossRef Shanmugam G, MacArthur K, Pollock JC. Congenital lung malformations—antenatal and postnatal evaluation and management. Eur J Cardiothorac Surg. 2005;27:45–52.CrossRef
4.
go back to reference Corbett HJ, Humphrey GM. Pulmonary sequestration. Paediatr Respir Rev. 2004;5:59–68.CrossRef Corbett HJ, Humphrey GM. Pulmonary sequestration. Paediatr Respir Rev. 2004;5:59–68.CrossRef
5.
go back to reference Baird R, Puligandla PS, Laberge JM. Congenital lung malformations: informing best practice. Semin Pediatr Surg. 2014;23:270–7.CrossRef Baird R, Puligandla PS, Laberge JM. Congenital lung malformations: informing best practice. Semin Pediatr Surg. 2014;23:270–7.CrossRef
6.
go back to reference Han P, Luo Y, Tian D, Yan W, Liu J, Chang Y. Pulmonary sequestration presenting with left upper abdominal bloating and marked elevation of serum carbohydrate antigen 19-9: a case report. Oncol Lett. 2014;7:1493–6.CrossRef Han P, Luo Y, Tian D, Yan W, Liu J, Chang Y. Pulmonary sequestration presenting with left upper abdominal bloating and marked elevation of serum carbohydrate antigen 19-9: a case report. Oncol Lett. 2014;7:1493–6.CrossRef
7.
go back to reference Winters WD, Effmann EL. Congenital masses of the lung: prenatal and postnatal imaging evaluation. J Thorac Imaging. 2001;16:196–206.CrossRef Winters WD, Effmann EL. Congenital masses of the lung: prenatal and postnatal imaging evaluation. J Thorac Imaging. 2001;16:196–206.CrossRef
8.
go back to reference Cho MJ, Kim DY, Kim SC, Kim KS, Kim EA, Lee BS. Embolization versus surgical resection of pulmonary sequestration: clinical experiences with a thoracoscopic approach. J Pediatr Surg. 2012;47:2228–33.CrossRef Cho MJ, Kim DY, Kim SC, Kim KS, Kim EA, Lee BS. Embolization versus surgical resection of pulmonary sequestration: clinical experiences with a thoracoscopic approach. J Pediatr Surg. 2012;47:2228–33.CrossRef
9.
go back to reference Herlyn M, Sears HF, Steplewski Z, Koprowski H. Monoclonal antibody detection of a circulating tumor-associated antigen. I. Presence of antigen in sera of patients with colorectal, gastric, and pancreatic carcinoma. J Clin Immunol. 1982;2:135–40.CrossRef Herlyn M, Sears HF, Steplewski Z, Koprowski H. Monoclonal antibody detection of a circulating tumor-associated antigen. I. Presence of antigen in sera of patients with colorectal, gastric, and pancreatic carcinoma. J Clin Immunol. 1982;2:135–40.CrossRef
10.
go back to reference Ambiru S, Nakamura S, Fukasawa M, Mishima O, Kuwahara T, Takeshi A. Intralobar pulmonary sequestration associated with marked elevation of serum carbohydrate antigen 19-9. Ann Thorac Surg. 2009;88:2010–1.CrossRef Ambiru S, Nakamura S, Fukasawa M, Mishima O, Kuwahara T, Takeshi A. Intralobar pulmonary sequestration associated with marked elevation of serum carbohydrate antigen 19-9. Ann Thorac Surg. 2009;88:2010–1.CrossRef
11.
go back to reference Matsuoka Y, Endo K, Kawamura Y, Yoshida T, Saga T, Watanabe Y, et al. Normal bronchial mucus contains high levels of cancer-associated antigens, CA125, CA19-9, and carcinoembryonic antigen. Cancer. 1990;65:506–10.CrossRef Matsuoka Y, Endo K, Kawamura Y, Yoshida T, Saga T, Watanabe Y, et al. Normal bronchial mucus contains high levels of cancer-associated antigens, CA125, CA19-9, and carcinoembryonic antigen. Cancer. 1990;65:506–10.CrossRef
12.
go back to reference Komatsu H, Mizuguchi S, Izumi N, Inoue H, Oka H, Suehiro S, et al. Pulmonary sequestration presenting elevated CA19-9 and CA125 with ovarian cysts. Ann Thorac Cardiovasc Surg. 2014;20(Suppl):686–8.CrossRef Komatsu H, Mizuguchi S, Izumi N, Inoue H, Oka H, Suehiro S, et al. Pulmonary sequestration presenting elevated CA19-9 and CA125 with ovarian cysts. Ann Thorac Cardiovasc Surg. 2014;20(Suppl):686–8.CrossRef
13.
go back to reference Dewan M, Malatani TS, Osinowo O, Nour M, Zahrani ME. Carcinoid tumorlets associated with diffuse bronchiectasis and intralobar sequestration. R Soc Health. 2000;120:192–5.CrossRef Dewan M, Malatani TS, Osinowo O, Nour M, Zahrani ME. Carcinoid tumorlets associated with diffuse bronchiectasis and intralobar sequestration. R Soc Health. 2000;120:192–5.CrossRef
14.
go back to reference Pelosi G, Zancanaro C, Sbabo L, Bresaola E, Martignoni G, Bontempini L. Development of innumerable neuroendocrine tumorlets in pulmonary lobe scarred by intralobar sequestration. Immunohistochemical and ultrastructural study of an unusual case. Arch Pathol Lab Med. 1992;116:1167–74.PubMed Pelosi G, Zancanaro C, Sbabo L, Bresaola E, Martignoni G, Bontempini L. Development of innumerable neuroendocrine tumorlets in pulmonary lobe scarred by intralobar sequestration. Immunohistochemical and ultrastructural study of an unusual case. Arch Pathol Lab Med. 1992;116:1167–74.PubMed
Metadata
Title
Elevated tumor markers in a benign lung disease
Authors
Quan Chen
Qijue Lu
Xiang Fei
Chunguang Li
Bai Li
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-021-01688-4

Other articles of this Issue 1/2021

Journal of Cardiothoracic Surgery 1/2021 Go to the issue