Exploiting the relevance of CA 19-9 in pancreatic cancer

Salleh, S.K.A.; Thyagarajan, Anita; Sahu, Ravi P.

doi:10.20517/2394-4722.2020.70

Cited by 8 publications

(6 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In normal pancreatic tissue, protein glycosylation produces end-products, which function as a lubricant for pancreatic ducts. However, an aberrant process occurs in cancer tissues, leading to the production of CA 19-9 [ 6 ]. Currently, CA 19-9 or Sla are the only tumor markers approved by the Food and Drug Administration (FDA) in the United States to support the diagnosis of pancreatic cancer [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Low Carbohydrate Antigen 19-9 (CA 19-9) Levels in a Patient Highly Suspected of Having Caput Pancreas Tumor

Yong¹,

Diyana²

2022

Cureus

View full text Add to dashboard Cite

Pancreatic cancer is the seventh leading cause of cancer-related mortality worldwide and the eleventh most common cause of cancer-related death in Indonesia. In pancreatic cancer, rapid and early diagnosis is crucial. Carbohydrate antigen 19-9 (CA 19-9), the most sensitive and specific tumor marker for pancreatic cancer, may help in diagnosing and determining prognosis; however, some populations do not express CA 19-9. Cases of low CA 19-9 may occur in populations with Lewis ⍺-β- genotype. These populations are not able to express Lewis antigen and CA 19-9; therefore, CA 19-9 investigation cannot be used for diagnostic and therapeutic measures. In patients highly suspicious of pancreatic cancer where CA 19-9 levels are low, alternative tumor markers such as CA 125 and carcinoembryonic antigen or a combination of various tumor markers can be used to increase sensitivity and specificity in diagnosing pancreatic cancer. A 70-year-old man presented with a complaint of worsening abdominal pain for the last two days. The patient had dark-yellow urine and pale stool. Abdominal ultrasonography and computed tomography scan showed a mass on the head of the pancreas, which was highly suspicious of pancreatic cancer.

show abstract

Section: Discussionmentioning

confidence: 99%

Low Carbohydrate Antigen 19-9 (CA 19-9) Levels in a Patient Highly Suspected of Having Caput Pancreas Tumor

Yong¹,

Diyana²

2022

Cureus

View full text Add to dashboard Cite

show abstract

“…Tumoral biomarkers' relevance in diagnosis, prognosis, and surgical decision-making processes is still a matter of debate ( 29 , 30 ). Ca 19-9 it's one of the most studied; Santucci et al ( 31 , 32 ), found that major levels of CA 19-9 in patients with locally advanced pancreatic cancer or metastatic disease compared with those with resectable disease; however, limitations among the use of CA 19-9 in clinical practice includes that almost 50% of patients with tumors < 2 cm do not elevate any tumoral biomarker and for that reason, currently there is still a lack of evidence in terms of prognosis ( 30 ). Our study did not find any statistical difference between CA 19-9 levels in patients with positive HLA compared with the negative group.…”

Section: Discussionmentioning

confidence: 99%

Hepatic artery lymph node relevance in periampullary tumors: A retrospective analysis of survival outcomes

et al. 2022

View full text Add to dashboard Cite

BackgroundThe Periampullary area comprehends a heterogeneous and complex structure with different histological tissues. Surgical standards include the peripancreatic regional lymphadenectomy, and during pancreatoduodenectomy (PD) the hepatic artery lymph node HALN(8a) is dissected. We aimed to describe the prognostic significance of the HALN(8a) lymph node metastasis in terms of disease-free survival (DFS) and overall survival (OS) in a specific cohort of patients in limited economic and social conditions.MethodsA retrospective study was conducted based on a prospective database from the HPB department of patients who underwent pancreaticoduodenectomy (PD) due to periampullary tumors during 2014–2021. Overall survival (OS) and disease-free survival (DFS) were estimated to be associated with positive HALN(8a) using Kaplan-Meier analysis. Log Rank test and Cox proportional hazards regression analysis was used.Results111 patients were included, 55,4% female. The most frequent pathology was ductal adenocarcinoma (60.3%). The positive rate of the HALN(8a) node was 21.62%. The Median OS time was 25.5 months, and the median DFS time was 13,8 months. Positive HLAN(8a) node, the cutoff of lymph node ratio resection (LNRR), and vascular invasion showed a strong association with OS. (CoxRegression p = 0.03 HR 0.5, p 0.003 HR = 1.8, p = 0.02 HR 0.4 CI 95%). In terms of DFS, lymph node ratio cutoff, tumoral size, and vascular invasion showed a statistically significant association with the outcome (p = 0.008, HR = 1.5; p = 0.04 HR = 2.1; p = 0.02 HR = 0.4 CI 95%).ConclusionIn this series of PD, OS was reduced in patients with HALN(8a) compromise in patients with pancreatic cancer, however without statistical significance in DFS. In multivariate analysis, lymph node status remains an independent predictor of OS and DFS. Further studies are needed.

show abstract

“…Current diagnostic methods and clinical biomarkers, such as serum carbohydrate antigen 19-9 (CA19-9)—the gold standard biomarker for PDAC diagnosis and the only diagnostic serum marker approved by the Food and Drug Administration (FDA) for pancreatic cancer– are limited in their capacity to accurately detect early-stage PDAC. This is because ~7% of the population do not express the antigen and the high occurrence of false positives and non-specific expression of CA19-9 compromise the differential diagnosis between malignant adenocarcinomas and benign pancreato-biliary pathologies, including chronic pancreatitis (CP), cholangitis and obstructive jaundice [ 126 , 127 , 128 , 129 ]. As such, CA19-9 is generally supported for the assessment of recurrence or survival after curative resection, rather than an initial or early-stage diagnostic screening [ 130 , 131 , 132 ].…”

Section: Clinical Evidence Supporting Upas Overexpression In Pancreat...mentioning

confidence: 99%

The Urokinase Plasminogen Activation System in Pancreatic Cancer: Prospective Diagnostic and Therapeutic Targets

2022

View full text Add to dashboard Cite

Pancreatic cancer is a highly aggressive malignancy that features high recurrence rates and the poorest prognosis of all solid cancers. The urokinase plasminogen activation system (uPAS) is strongly implicated in the pathophysiology and clinical outcomes of patients with pancreatic ductal adenocarcinoma (PDAC), which accounts for more than 90% of all pancreatic cancers. Overexpression of the urokinase-type plasminogen activator (uPA) or its cell surface receptor uPAR is a key step in the acquisition of a metastatic phenotype via multiple mechanisms, including the increased activation of cell surface localised plasminogen which generates the serine protease plasmin. This triggers multiple downstream processes that promote tumour cell migration and invasion. Increasing clinical evidence shows that the overexpression of uPA, uPAR, or of both is strongly associated with worse clinicopathological features and poor prognosis in PDAC patients. This review provides an overview of the current understanding of the uPAS in the pathogenesis and progression of pancreatic cancer, with a focus on PDAC, and summarises the substantial body of evidence that supports the role of uPAS components, including plasminogen receptors, in this disease. The review further outlines the clinical utility of uPAS components as prospective diagnostic and prognostic biomarkers for PDAC, as well as a rationale for the development of novel uPAS-targeted therapeutics.

show abstract

Exploiting the relevance of CA 19-9 in pancreatic cancer

Cited by 8 publications

References 48 publications

Low Carbohydrate Antigen 19-9 (CA 19-9) Levels in a Patient Highly Suspected of Having Caput Pancreas Tumor

Low Carbohydrate Antigen 19-9 (CA 19-9) Levels in a Patient Highly Suspected of Having Caput Pancreas Tumor

Hepatic artery lymph node relevance in periampullary tumors: A retrospective analysis of survival outcomes

The Urokinase Plasminogen Activation System in Pancreatic Cancer: Prospective Diagnostic and Therapeutic Targets

Contact Info

Product

Resources

About