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{{chembox |
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{{Chembox |
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| Name = Sialyl-Lewis<sup>A</sup> |
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| verifiedrevid = 409334500 |
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| ImageFile = Sialyl lewis a.svg |
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| ImageFile = Sialyl lewis a.svg |
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| ImageSize = 200px |
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| ImageSize = 200px |
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| SystematicName = (1<sup>2</sup>''S'',1<sup>4</sup>''S'',1<sup>5</sup>''R'',1<sup>6</sup>''R'',3<sup>2</sup>''R'',3<sup>3</sup>''R'',3<sup>4</sup>''S'',3<sup>5</sup>''S'',3<sup>6</sup>''R'',5<sup>2</sup>''R'',5<sup>3</sup>''S'',5<sup>4</sup>''R'',5<sup>5</sup>''R'',5<sup>6</sup>''Ξ'',7<sup>2</sup>''S'',7<sup>3</sup>''S'',7<sup>4</sup>''R'',7<sup>5</sup>''S'',7<sup>6</sup>''S'')-1<sup>5</sup>,5<sup>5</sup>-Diacetamido-1<sup>4</sup>,3<sup>3</sup>,3<sup>5</sup>,5<sup>6</sup>,7<sup>3</sup>,7<sup>4</sup>,7<sup>5</sup>-heptahydroxy-3<sup>6</sup>,5<sup>2</sup>-bis(hydroxymethyl)-7<sup>6</sup>-methyl-1<sup>6</sup>--2,4,6-trioxa-1,7(2),3(4,2),5(4,3)-tetraoxanaheptaphane-1<sup>2</sup>-carboxylic acid |
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| IUPACName = |
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| OtherNames = sialyl Le<sup>A</sup>, SLe<sup>A</sup>, cancer antigen 19-9, CA19-9 |
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| OtherNames = |
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| Section1 = {{Chembox Identifiers |
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|Section1={{Chembox Identifiers |
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| CASNo = 92448-22-1 |
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| CASNo = 92448-22-1 |
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| CASNo_Ref = {{cascite|correct|CAS}} |
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| SMILES = O=C(O)1(O2(O)(CO)O(O3(O4(O)(O)(O)(C)O4)(CO)OC(O)3NC(C)=O)2O)C(O)(NC(C)=O)((O)(O)CO)O1 |
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| ChEBI = 61793 |
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| MeSHName = sialyl+Lewis+A |
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| ChemSpiderID = 9160877 |
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| PubChem = 10985677 |
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| UNII_Ref = {{fdacite|correct|FDA}} |
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| UNII = ZEJ6FM4UJK |
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| SMILES = O=C(O)1(O2(O)(CO)O(O3(O4(O)(O)(O)(C)O4)(CO)OC(O)3NC(C)=O)2O)C(O)(NC(C)=O)((O)(O)CO)O1 |
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| MeSHName = sialyl+Lewis+A |
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| Section2 = {{Chembox Properties |
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|Section2={{Chembox Properties |
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| C=31|H=52|N=2|O=23 |
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| C=31 | H=52 | N=2 | O=23 |
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| Section3 = {{Chembox Hazards |
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'''Carbohydrate antigen 19-9''' ('''CA19-9'''), also known as '''sialyl-Lewis<sup>A</sup>''', is a ] which is usually attached to O-]s on the surface of cells. It is known to play a role in cell-to-cell recognition processes. It is also a ] used primarily in the management of ].<ref name=Perkins>{{Cite journal | last1 = Perkins | first1 = G. | last2 = Slater | first2 = E. | last3 = Sanders | first3 = G. | last4 = Prichard | first4 = J. | title = Serum tumor markers | journal = American Family Physician | volume = 68 | issue = 6 | pages = 1075–1082 | year = 2003 | pmid = 14524394 | url= http://www.aafp.org/afp/2003/0915/p1075.html}}</ref> |
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==Structure== |
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'''Sialyl Lewis<sup>A</sup>''', also known as ''sialyl Le<sup>A</sup>'' and ''SLe<sup>A</sup>'', is a tetrasaccharide ] that is usually attached to O-] on the surface of cells. It is known to play a vital role in cell-to-cell recognition processes. |
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CA19-9 is the sialylated form of ]. It is a ] with the sequence Neu5Acα2-3Galβ1-3GlcNAcβ. |
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==Clinical significance== |
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Occurrence of the Sialyl Lewis <sup>A</sup> antigen, detected with the ] antibody, is highly correlated advanced epithelial cancers, such as stage III and stage IV colorectal cancers.<ref name="CRcancer">{{cite journal | author = Matsui T, Kojima T, Suzuki H, Hamajima H, Nakazato H, Ito K, Nakao A, Sakamoto J. | title = Sialyl Lewisa Expression as a Predictor of the Prognosis of Colon Carcinoma Patients in a Prospective Randomized Clinical Trial | journal = Japanese Journal of Clinical Oncology | volume = 34 | issue = 10 | pages = 588–593 | year = 2004 | month = June | pmid = | doi = 10.1093/jjco/hyh110 | url = http://jjco.oxfordjournals.org/cgi/content/full/34/10/588 }}</ref> |
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===Tumor marker=== |
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Guidelines from the ] discourage the use of CA19-9 as a screening test for cancer, particularly ]. The reason is that the test may be falsely normal (]) in many cases or abnormally elevated in people who have no cancer (]) in others. The main use of CA19-9 is therefore to see whether a pancreatic tumor is secreting it; if that is the case, then the levels should fall when the tumor is treated, and they may rise again if the disease recurs.<ref name=Asco>{{cite journal |vauthors=Locker G, Hamilton S, Harris J, Jessup J, Kemeny N, Macdonald J, Somerfield M, Hayes D, Bast R |title=ASCO 2006 update of recommendations for the use of tumor markers in gastrointestinal cancer |journal=J. Clin. Oncol. |volume=24 |issue=33 |pages=5313–27 |year=2006 |pmid=17060676|url=http://jco.ascopubs.org/cgi/content/full/24/33/5313 |doi=10.1200/JCO.2006.08.2644}}</ref> Therefore it is useful as a surrogate marker for ]. |
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In people with ]es, CA19-9 can be useful in distinguishing between cancer and other diseases of the gland.<ref name=Perkins/><ref name=Goonetilleke/> |
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== See also == |
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* ] |
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== References == |
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====Limitations==== |
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CA19-9 can be elevated in many types of gastrointestinal cancer, such as ], ] and ].<ref name=Perkins/> Apart from cancer, elevated levels may occur in ], ],<ref name=Perkins/> and diseases of the bile ducts.<ref name=Perkins/><ref name=Goonetilleke/> It can also be elevated in people with obstruction of the ]s.<ref name=Goonetilleke/> |
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In people who lack Lewis antigen<sup>A</sup> (a blood type antigen on ]s), which is about 10% of the white population, CA19-9 is not produced by any cells,<ref name=Goonetilleke>{{cite journal |vauthors=Goonetilleke KS, Siriwardena AK |title=Systematic review of carbohydrate antigen (CA19-9) as a biochemical marker in the diagnosis of pancreatic cancer |journal=Eur J Surg Oncol |volume=33 |issue=3 |pages=266–70 |date=April 2007 |pmid=17097848 |doi=10.1016/j.ejso.2006.10.004}}</ref> even in those with large tumors.<ref name=Asco/> This is because of a deficiency of a ] enzyme that is needed to produce Lewis antigen<sup>A</sup>.<ref name=Asco/> |
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==History== |
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CA19-9 was discovered in the serum of patients with ] and ] in 1981.<ref name="pmid6163212">{{cite journal |vauthors=Koprowski H, Herlyn M, Steplewski Z, Sears HF |title=Specific antigen in serum of patients with colon carcinoma |journal=Science |volume=212 |issue=4490 |pages=53–5 |year=1981 |pmid=6163212 |doi=10.1126/science.6163212|bibcode=1981Sci...212...53K }}</ref> It was characterized shortly after, and it was found to be carried primarily by ].<ref>{{cite journal|last1=Magnani|first1=JL|title=The discovery, biology, and drug development of sialyl Lea and sialyl Lex.|journal=Archives of Biochemistry and Biophysics|date=15 June 2004|volume=426|issue=2|pages=122–31|pmid=15158662|doi=10.1016/j.abb.2004.04.008}}</ref> |
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== See also== |
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* ] |
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* ] |
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==References== |
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{{reflist}} |
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{{reflist}} |
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==External links== |
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* {{MeshName|CA-19-9+Antigen}} |
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* CA19-9 at |
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* - The Association for Clinical Biochemistry and Laboratory Medicine |
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{{Tumor markers}} |
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