CA 50: a tumor marker for gastrointestinal malignancies

Abstract

Efforts to find the ideal tumor marker, together with the advanced knowledge of the carbohydrate expression by cancer and the development of monoclonal antibody technology have facilitated the generation of many new tests used in clinical oncology. CA 50, a novel cancer-associated carbohydrate marker, is detected by the C 50 antibody that has been obtained by immunization of mice with a human colorectal adenocarcinoma cell line. This antibody that defines CA 50 reacts with both the afucosyl form of sialylated Lewis(a) carbohydrate moiety and sialylated Lewis(a) moiety which is also the antigenic epitope in the CA 19-9 assay. CA 50 is not organ-specific and its elevated levels in serum can be observed in a variety of malignancies, especially gastrointestinal cancers. In contrast to CA 19-9, high CA 50 levels can also be seen in malignant tumors outside the digestive tract. The expectation, that CA 50 might be positive in the Lewis negative patients who cannot synthesize CA 19-9, is supported by the histoimmunologic study. However, in serum determination close correlation between CA 50 and CA 19-9 has been observed even in patients who have Lewis negative phenotype. In clinical application, CA 50 is marginally beneficial for the diagnosis, but very useful for the follow-up of patients with pancreatic cancers. It gives results rather similar to CA 19-9. Moderately high serum levels of CA 50 can also be seen in benign hepatobiliary diseases, especially in jaundice cases. Therefore, this should be considered in order to obtain the most advantage of the marker. For other gastrointestinal cancers, CA 50 in combination with other previously defined markers may give additional information for the evaluation of some patients with colorectal, biliary, or gastric cancers. At present, there are many new emerging tumor markers used in clinical oncology. Increasing our knowledge about these markers, their capabilities and limitations will enable us to use them effectively in the evaluation of cancer patients.