Comparison of Urinary and Serum CA 19-9 as Markers of Early Stage Urothelial Carcinoma

Roy, Suparna; Dasgupta, Anindya; Kar, Kaushik

doi:10.1590/s1677-5538.ibju.2013.05.04

Cited by 14 publications

(8 citation statements)

References 19 publications

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“…Results similar to ours were also observed by another group, although they assayed only 5 urine samples [57]. Interestingly, urinary CA19-9 was found to be superior to its serum counterpart in the diagnosis of low-grade and early stages of TCC of urinary bladder [58]. Increased levels of CA19-9 were seen in urine due to urothelial obstruction [59] and renal injury [60], indicating the local production and secretion of this glycolipid into urine.…”

Section: Plos Medicinesupporting

confidence: 87%

A combination of urinary biomarker panel and PancRISK score for earlier detection of pancreatic cancer: A case–control study

et al. 2020

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Background Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest cancers, with around 9% of patients surviving >5 years. Asymptomatic in its initial stages, PDAC is mostly diagnosed late, when already a locally advanced or metastatic disease, as there are no useful biomarkers for detection in its early stages, when surgery can be curative. We have previously described a promising biomarker panel (LYVE1, REG1A, and TFF1) for earlier detection of PDAC in urine. Here, we aimed to establish the accuracy of an improved panel, including REG1B instead of REG1A, and an algorithm for data interpretation, the PancRISK score, in additional retrospectively collected urine specimens. We also assessed the complementarity of this panel with CA19-9 and explored the daily variation and stability of the biomarkers and their performance in common urinary tract cancers. Methods and findings Clinical specimens were obtained from multiple centres: Barts Pancreas Tissue Bank, University College London, University of Liverpool, Spanish National Cancer Research Center, Cambridge University Hospital, and University of Belgrade. The biomarker panel was assayed on 590 urine specimens: 183 control samples, 208 benign hepatobiliary disease samples (of which 119 were chronic pancreatitis), and 199 PDAC samples (102 stage I–II and 97 stage III–IV); 50.7% were from female individuals. PDAC samples were collected from patients before treatment. The samples were assayed using commercially available ELISAs. Statistical analyses were performed using non-parametric Kruskal–Wallis tests adjusted for multiple comparisons, and multiple logistic regression. Training and validation datasets for controls and PDAC samples were obtained after random division of the whole available dataset in a 1:1 ratio. The substitution of REG1A with REG1B enhanced the performance of the panel to detect resectable PDAC. In a comparison of controls and PDAC stage I–II samples, the areas under the receiver operating characteristic curve (AUCs) increased from 0.900 (95% CI 0.843–0.957) and 0.926 (95% CI 0.843–1.000) in the training (50% of the dataset) and validation sets, respectively, to 0.936 in both the training (95% CI 0.903–0.969) and the validation (95% CI 0.888–0.984) datasets for the new panel including REG1B. This improved panel showed both sensitivity (SN) and specificity (SP) to be >85%. Plasma CA19-9 enhanced the performance of this panel in discriminating PDAC I–II patients from controls, with AUC = 0.992 (95% CI 0.983–1.000), SN = 0.963 (95% CI 0.913–1.000), and SP = 0.967 (95% CI 0.924–1.000). We demonstrate that the biomarkers do not show significant daily variation, and that they are stable for up to 5 days at room temperature. The main limitation of our study is the low number of stage I–IIA PDAC samples (n = 27) and lack of samples from individuals with hereditary predisposition to PDAC, for which specimens collected from control individuals were used as a proxy. Conclusions We have successfully validated our urinary biomarker panel, which was improved by substituting REG1A with REG1B. At a pre-selected cutoff of >80% SN and SP for the affiliated PancRISK score, we demonstrate a clinically applicable risk stratification tool with a binary output for risk of developing PDAC (‘elevated’ or ‘normal’). PancRISK provides a step towards precision surveillance for PDAC patients, which we will test in a prospective clinical study, UroPanc.

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Section: Plos Medicinesupporting

confidence: 87%

A combination of urinary biomarker panel and PancRISK score for earlier detection of pancreatic cancer: A case–control study

et al. 2020

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“…The CA 19-9 is over expressed in a broad spectrum of gastrointestinal and extra-gastrointestinal benign and malignant diseases. [11][12][13][14][15][16][17] However, given that its primary implications were discovered for PACs, the CA 19-9 prevails as an essential biomarker in routine clinical use for the diagnosis, staging, management, and prognostication of PAC patients undergoing various anti-cancer treatments. [16][17][18] Concerning the prognostic value of CA 19-9, several investigations have found a significant association between the diminished survival results and higher CA 19-9 levels, even though variable cutoffs were adopted in these studies.…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Significance of Novel Pancreas Cancer Prognostic Index in Unresectable Locally Advanced Pancreas Cancers Treated with Definitive Concurrent Chemoradiotherapy

Topkan¹,

Selek²,

Pehlivan³

et al. 2021

JIR

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Purpose: We evaluated the prognostic quality of the novel pancreas cancer prognostic index (PCPI), a combination of CA 19-9 and systemic inflammation response index (SIRI), on the outcomes of locally advanced pancreas adenocarcinoma (LAPAC) patients who received concurrent chemoradiotherapy (C-CRT). Methods: This retrospective analysis covered 152 unresectable LAPAC patients treated from 2007 to 2019. Receiver operating characteristic (ROC) curve analysis was used to define ideal cutoff thresholds for the pretreatment CA 19-9 and SIRI measurements, individually. The associations between the PCPI groups and progression-free-(PFS) and overall survival (OS) comprised the respective primary and secondary endpoints. Results: The ROC curve analysis distinguished the respective rounded optimal cutoffs at 91 U/m/ L (< versus ≥90) and 1.8 (< versus ≥1.8) for CA 19-9 and SIRI, arranging the study cohort into two significantly different survival groups for each, with resultant four likely groups: Group-1: CA 19-9<90 U/m/L and SIRI<1.8, Group-2: CA 19-9<90 U/m/L but SIRI≥1.8, Group-3: CA 19-9≥90 U/ m/L but SIRI<1.8, and Group-4: CA 19-9≥90 U/m/L and SIRI≥1.8. Since the PFS (P=0.79) and OS (P=0.86) estimates of the groups 2 and 3 were statistically indistinct, we merged them as one group and created the novel three-tiered PCPI:

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“…The detection oncomarkers has been classified into following groups (Table 2). The most commonly used detection on co-markers are serological that used enzymes (72)(73)(74)(75)(76).…”

Section: Detection Oncomarkersmentioning

confidence: 99%

Genetic biomarkers: Potential roles in cancer diagnosis

Khailany

Aziz

Najjar

et al. 2020

Cell Mol Biol (Noisy-le-grand)

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Biomarkers are indicators of pathogenic processes, typical biological processes, or pharmacological reactions to a therapy. It has several potential usages in cancer; differential diagnosis, prognosis, risk assessment, therapeutic response, and monitoring of disease progression. Recently, advances in oncomarkers raised significant opportunities for enhancing management of cancer. Chromosomal aberration, molecular impairment and epigenetic alteration might be applied to diagnose and prognose cancer and its epidemiology. Some oncomarkers are specific and highly sensitive for detection. An oncomarker might be used to see how the body reacts to an intervention or a situation. The present study represents a short review about various genetic oncomarkers with diagnostic and prognostic values.

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Comparison of Urinary and Serum CA 19-9 as Markers of Early Stage Urothelial Carcinoma

Cited by 14 publications

References 19 publications

A combination of urinary biomarker panel and PancRISK score for earlier detection of pancreatic cancer: A case–control study

A combination of urinary biomarker panel and PancRISK score for earlier detection of pancreatic cancer: A case–control study

The Prognostic Significance of Novel Pancreas Cancer Prognostic Index in Unresectable Locally Advanced Pancreas Cancers Treated with Definitive Concurrent Chemoradiotherapy

Genetic biomarkers: Potential roles in cancer diagnosis

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