Combined use of CEMIP and CA 19-9 enhances diagnostic accuracy for pancreatic cancer

Abstract

Carbohydrate antigen (CA) 19-9 is the only diagnostic marker used in pancreatic cancer despite its limitations. Here, we aimed to identify the diagnostic role of CEMIP (also called KIAA1199) combined with CA 19-9 in patients with pancreatic cancer. A retrospective analysis of prospectively collected patient samples was performed to determine the benefit of diagnostic markers in the diagnosis of pancreatic cancer. We investigated CEMIP and CA 19-9 levels in 324 patients with pancreatic cancer and 49 normal controls using serum enzyme-linked immunosorbent assay. Median CA 19-9 and CEMIP levels were 410.5 U/ml (40.8–3342.5) and 0.67 ng/ml (0.40–1.08), respectively, in patients with pancreatic cancer. The AUROC for CA 19-9 and CEMIP were 0.847 (95% confidence interval [CI]: 0.806–0.888) and 0.760 (95% CI: 0.689–0.831), respectively. Combination of CA 19-9 with CEMIP showed markedly improved AUROC over CA 19-9 alone in pancreatic cancer diagnosis (0.94 vs. 0.89; P < 0.0001). CEMIP showed a diagnostic yield of 86.1% (68/79) in CA 19-9 negative pancreatic cancer. Combined use with CEMIP showed significantly improved diagnostic value compared with CA 19-9 alone in pancreatic cancer. Especially, CEMIP may be a complementary marker in pancreatic cancer patients with normal CA 19-9 levels.

Early detection of pancreatic cancer

“…The diagnostic value of CA19-9 may, in the future, be improved by measuring the antigen on individual proteins or using it in combination with additional markers. In the distinction of PDAC from benign disease and healthy controls, Lee et al 78 reported an improved AUC using a combination of CA19-9 and CEMIP (cell migration-inducing hyaluronan binding protein), a protein involved in the degradation of hyaluronan. compared to CA19-9 alone (0.94 vs 0.89).…”

The Use of Biomarkers in Early Diagnostics of Pancreatic Cancer

“…Results suggest that CEMIP proteins were highly expressed in patients with PDAC compared to healthy individuals. Combining the use of CA 19-9 and CEMIP significantly increased the sensitivity and specificity in discriminating not only patients with all stage pancreatic cancer, but also patients with stage I/II pancreatic cancer from healthy individuals [ 26 ].…”

Exploiting the relevance of CA 19-9 in pancreatic cancer

“…In the last decade, different biomarkers have been explored to identify a simpler tool for pancreatic cancer diagnosis and prognosis [8,9] . The development of tumour biomarkers are essential to precisely detect patients at their early stage of tumour growth, as well as to evaluate the treatment responses so that the current therapeutic strategies can be further improved [8][9][10][11] .…”

“…In the last decade, different biomarkers have been explored to identify a simpler tool for pancreatic cancer diagnosis and prognosis [8,9] . The development of tumour biomarkers are essential to precisely detect patients at their early stage of tumour growth, as well as to evaluate the treatment responses so that the current therapeutic strategies can be further improved [8][9][10][11] . Among various validated tools, alcohol dehydrogenase (ADH) isoenzymes, aldehyde dehydrogenase (ALDH) enzyme as well as carbohydrate antigen have been explored as the most common tumour markers for pancreatic cancer [8][9][10][11][12][13][14] .…”

“…In recent years, CA 19-9, also known as Sialylated Lewis antigen (Sla) has emerged as one of the moststudied biomarkers for PDAC, which was characterized by a monoclonal antibody produced by hybridoma technology [8][9][10][11] . As some mucins could contribute to cancer progression via mechanisms including the induction of T cell apoptosis, which later affects the anti-cancer immune response [10,11] , the human colorectal carcinoma cell line SW1116 was immunized with spleen cells of a mouse as a mucin-like product [11] .…”