Is CA19-9 a good marker of pancreatic cancer?

The prognosis of pancreatic cancer is extremely poor and early diagnosis is difficult. At the time of diagnosis, local vascular involvement, nodal and distant metastases are frequently present. Currently, the best way of preoperative staging of pancreatic cancer is bolus-contrast, triple-phase helical computed tomography. However, the positive predictive value of the test is low, and approximately 25%-50% of patients predicted to have resectable disease on computed tomography turn out to have unresectable lesions at laparotomy. CA19-9 is the most widely used pancreatic cancer serum markers. Its level has been shown to correlate with the TNM staging and the tumor sizes in patients with pancreatic cancer. But little is known about the value of serum CA19-9 levels in evaluating respectability of pancreatic carcinoma. A research article to be published on 21 June 2008, in the World Journal of Gastroenterology addresses this question. The research team led by Prof. Zhang from Department of Hepatobiliary Surgery in Affiliated Hospital of medical college of Qingdao University had retrospectivly studied the clinical data of 104 patients to evaluate the clinical value of serum CA19-9 levels in predicting respectability of pancreatic carcinoma according to receiver operating characteristic (ROC) curve analysis.

They found that the area under the ROC curve was 0.918, 95% CI were 0.843-0.992; The left-hand corner cut-off CA19-9 level is 353.15 U/mL, the sensitivity and specificity was 93.1% and 78.3% respectively; Positive and negative predictive values was 84.38% and 90% according to this level. According to statistic principle, preoperative serum CA 19-9 level is a useful marker for evaluating respectability of pancreatic cancer. Obviously increased serum levels of CA19-9 can be regarded as the ancillary parameter for the unresectable pancreatic cancer. These will increase the accurate of predicting respectability of pancreatic carcinoma and avoid unnecessary laparotomy.

Source: World Journal of Gastroenterology