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SERUM TUMOR MARKER CARBOHYDRATE ANTIGEN 19-9 FOR THE DIAGNOSIS AND PROGNOSIS OF PANCEREATIC CANCER
Author(s): 
Pages: 74-80
Year: Issue:  1
Journal: China Medical Abstracts

Keyword:  Pancreatic neowplasmaCA19、9;
Abstract: Objective To evaluate serum tumor marker carbohydrate antigen 19-9 (CA 19-9) for the diagnosis and prognosis of pancreatic cancer.Patients and Methods Serum CA 19-9 levels were determined serially by immunoradiometric assay in 40 patients with pancreatic cancer,92 with other gastrointestinal cancers and 115 with benign pancreatiobiliary diseases.In the patients with pancreatic cancer,preoperative examinations include routine ultrasonography,CT-scan of the adbomen,MRCP and/or ERCP;clinical courses with respect to the pathological data,surgical procedures employed and the prognosis of these patients were followed up and compared.Results Serum CA 19-9 level (196.7±98.8 U/ml) and the positive rate (90.0%) in patients with pancreatic cancer were significantly higher than those with the cancers of the liver (70.6±60.0 U/ml,58.3%,P<0.01),gastroduodenum (34.9±55.3 U/ml,6.3%,P<0.01),colorectum (29.8±44.8 U/ml,21.9%,P<0.01),and those with pancreatitis (10.2±13.7 U/ml,6.3%,P<0.01),jaundice due to choledocholithiasis (46.7±43.0 U/ml,40.7%,P<0.01),cholecystitis with gallstones (13.5±15.4 U/ml,10.0%,P<0.01),etc.,respectively.When 100 U/ml was taken as the cut-off value,the specificity and the accuracy of serum CA 19-9 for the diagnosis of pancreatic cancer reached form 68.5% and 74.6% to 83.4% and 81.6%,respectively.If combined examinations of CA 19-9 with ultrasonography,CT and MRCP/ERCP were conduced;the diagnostic accuracy might recah 100% and might be helpful for differentiating from extrahepatic bile duct cancer.There were no significant relations between the serum CA 19-9 level and clinicopathological features of pancreatic cancer such as staging,size and location.Serum CA 19-9 level decreased rapidly to the normal range after tumor resection,whereas a secondary elevation of the levels was observed before the locoregional recurrence and distant metastases of the disease after operation.Conclusion Serum CA 19-9 may be of useful tumor marker for diagnosis of pancreatic carcinoma,prediction of the prognosis of the patients after resection and monitoring the metastases and recurrence of the disease.
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