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A group of mucin type glycoprotein Sialosyl Lewis Antigens (SLA), such as CA19-9 and CA19-5, havecome to be recognized as circulating cancer associated antigens for gastrointestinal cancer. CA19-9represents the most important and basic carbohydrate tumor marker. The immunohistologic distribution ofCA19-9 in tissues is consistent with the quantitative determination of higher CA19-9 concentrations incancer than in normal or inflamed tissues. Recently reports indicates that the serum CA19-9 level isfrequently elevated in the serum of subjects with various gastrointestinal malignancies, such as pancreatic,colorectal, gastric and hepatic carcinomas. Together with CEA, elevated CA19-9 is suggestive ofgallbladder neoplasm in the setting of inflammatory gallbladder disease. This tumor-associated antigenmay also be elevated in some non-malignant conditions. Research studies demonstrate that serum CA19-9 values may have utility in monitoring subjects with the above-mentioned diagnosed malignancies. Ithas been shown that a persistent elevation in serum CA19-9 value following treatment may be indicative ofoccult metastatic and/or residual disease. A persistently rising serum CA 19-9 value may be associatedwith progressive malignant disease and poor therapeutic response. A declining CA 19-9 value may beindicative of a favorable prognosis and good response to treatment.