Prognostic value of serum CEA and CA19‑9 levels in pancreatic ductal adenocarcinoma

Abstract

The present study investigated the associations of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels with clinicopathological variables and survival outcomes in Libyan patients with pancreatic ductal adenocarcinoma (PDAC). The clinicopathological variables of 123 patients with PDAC registered at the National Cancer Institute in Misurata, Libya, between 2010 and 2018 were retrospectively analyzed. Blood samples from these patients were analyzed for serum CEA and CA19-9 levels before treatment by electrochemiluminescence immunoassay (double antibody sandwich ELISA) on a Roche cobas e 602 modules. The relationships between CA19-9 and CEA serum levels with clinicopathologic variables and survival outcomes were analyzed using the Kaplan-Meier method, log-rank test and Cox regression analyzes. Cut-off values for serum CEA and CA19-9 levels were 5 ng/ml and 400 U/ml, respectively. The median serum levels of all patients with PDAC for CEA and CA19-9 were 8 ng/ml (1.1-377 ng/ml) and 389 U/ml (1-10,050 U/ml), respectively. Tumors with higher serum CEA and CA19-9 levels were found in 63 and 48% of patients, respectively. Higher CEA and CA19-9 serum levels were significantly associated with more indicators of a malignant phenotype, including a surgically unresectable tumor, unevaluable lymph nodes, advanced stages and distant metastases. Regarding survival, patients with higher serum levels of the biomarkers CEA and CA19-9 had shorter overall survival rates (P<0.016 and (P<0.014, log-rank, respectively) and lower disease-free survival rates (P<0.002 and P<0.0001, log-rank, respectively) . The present study demonstrated significant clinical and prognostic value of serum levels of biomarkers CEA and CA19-9 for Libyan patients with PDAC. Moreover, patients with PDAC with higher serum CEA and CA19-9 levels had more aggressive tumors, higher rates of disease recurrence and shorter overall survival rates and thus required more vigilant follow-up. Further multinational studies with larger PDAC cohorts are warranted to confirm these findings in terms of improved clinical decision making, more effective management and improved survival.

Can combined use of tumor markers in pancreatic cancer be a solution to short- and long-term consequences?: A retrospective study

“…There was a significant relationship between lymph node metastasis and Ca19-9 but not with CEA. These results were consistent with those of Ermiah et al [19] However, the difference in the current study was that the relationship between the Ca19-9/CEA ratio and the N grade was also examined. An increase in the Ca19-9 level increased the probability of the patient being N2 compared to the probability of N0.…”

Feasibility of 125I brachytherapy combined with arterial infusion chemotherapy in patients with advanced pancreatic cancer

“…[25] Higher CA19-9 serum levels were significantly associated with more malignant and the worse prognosis of pancreatic cancer. [28] In the study, CA19-9 decline percentage was much more obvious in patients who received 125 I brachytherapy combined with arterial infusion chemotherapy, which was consistent with the improvement of the LCR, median survival and survival rate. Liver is the most frequent site for distant metastasis as well as recurrence of pancreatic cancer.…”

Exosomal miRNA Biomarker Panel for Pancreatic Ductal Adenocarcinoma Detection in Patient Plasma: A Pilot Study

“…A biomarker panel consisting of these four miRNAs and a dual threshold cutoff consisting of the upper limit of the ΔCq values (99% CI) of the miRNAs from control samples and the lower limit of the ΔCq values of the miRNAs (99% CI) from PDAC samples resulted in a diagnostic with an AUC of 0.887, a sensitivity of 80%, and specificity of 94.7%. This is comparable to the current FDA-approved CA19-9 diagnostic, which exhibits both a variable sensitivity (70–90%) and specificity (68–91%) [ 31 ]. Interestingly, CA19-9 levels were reported as elevated in only 8 of the 15 (53.33%) PDAC patient samples collected for this study.…”