Serum CA 19-9 and CEA Levels as a Prognostic Factor in Pancreatic Adenocarcinoma

Abstract

PurposeTo investigate the use of pretreatment carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) as prognostic factors to determine survival in pancreatic adenocarcinoma.Materials and MethodsA retrospective review of the medical records of patients who were diagnosed with pancreatic adenocarcinoma and received surgery, chemoradiotherapy or chemotherapy was performed. Factors, including CA 19-9 and CEA, associated with the survival of pancreatic cancer patients were analyzed.ResultsPatients with the median age of 65 years were included (n=187). Elevated serum CA 19-9 levels and CEA levels were observed in 75.4% and 39% of patients at diagnosis, respectively. CEA was correlated with tumor stages (p=0.005), but CA 19-9 was not. CA 19-9 and CEA were elevated in 69.0% and 33.3% of patients with resectable pancreatic cancer, and elevated in 72.9% and 47.2% of patients with advanced pancreatic cancer, respectively. The median overall survival of the normal serum CEA group was longer than that of the elevated serum CEA group (16.3 months vs. 10.2 months, p=0.004). However, the median overall survival of the normal serum CA 19-9 group was not different from that of the elevated serum CA 19-9 group (12.4 months vs. 13.5 months, p=0.969). The independent factors associated with overall survival were advanced pancreatic cancer [harzard ratio (HR) 4.33, p=0.001] and elevated serum CEA level (HR 1.52, p=0.032).ConclusionPatients with elevated serum CEA level at diagnosis demonstrated poor overall survival. Pretreatment CEA level may predict the prognosis of patients with pancreatic adenocarcinoma.

Combination of tumour markers CEA and CA19-9 improves the prognostic prediction in patients with pancreatic cancer

“…Our study cohort with 393 examined patients is adequately large and has a long follow-up period. Concerning descriptive analyses of clinicopathological variables, results are widely comparable to many other publications (eg, age distribution, survival time distribution) 9 22. Nevertheless, because of the retrospective study design, we cannot fully exclude a selection bias in our study cohort.…”

“…Of course, to realise ROC analyses an additional classification variable like CSS status is needed. Certainly it should be taken into account when comparing results that sometimes just a simple dichotomy of elevated values is made (eg, the usual cut-off value between normal and abnormal range of CA19-9 is 37 U/L, for CEA 5 U/L9), which often leads automatically to circumstances that no feasible conclusions are possible. Ballehaninna et al 28 29 verified that preoperative patients with PC with CA19-9 values <37 U/L had a significant longer median survival compared with the group that had values above.…”

“…Many studies suggest that these pretherapeutic tumour marker values also seem to yield a prognostic significance in patients with PC, but in terms of declaring independent prognostic factors publications often provide controversial results for CEA as well as CA19-9. Some studies only see CEA as prognostic independent,9 10 other ones both markers,11–13 while still others none of them 14. One general problem to determine whether tumour markers imply a prognostic meaning in patients with PC is the narrowband survival distribution combined with the relative rareness of this disease in contrast to more common tumour entities.…”

Clinical Utility of Haptoglobin in Combination with CEA, NSE and CYFRA21-1 for Diagnosis of Lung Cancer

“…CEA is acid glycoprotein of human embryonic antigen specificity determinant, belongs to non-organ specific tumor associated antigen, the content is extremely small in the circulating blood of normal adult, the elevated degree has a closely relation with the proliferation of cancer cell, has been widely used in various types of tumors detection (Lee et al, 2013;Ding et al, 2014). The results of this study showed that the level of CEA in adenocarcinoma was significantly higher than that in squamous carcinoma and small cell cancer, indicating that CEA is the most valuable indicator for the diagnosis of lung adenocarcinoma.…”

CA 19-9 as a Serum Biomarker in Cancer

“…1: (Hess, et al, 2008) 2: (Katz, et al, 1998) 3: (Lee, et al, 2013), (Katz, et al, 1998) 4: (Bauer, et al, 2013) 5: (Haas, et al, 2013) 6: (Reni, et al, 2009) 7: (Yoo, et al, 2011) 8: (Haas, et al, 2013) Chemotherapy response has been assessed using serial CA 19-9 levels in several studies and it has been found that treatment-related decline in the biomarker is associated with better overall survival in some studies. There are several definitions for assessing the degree of decline such as !20 % decline as well !50-75 % decline from pretreatment values in the first 6-8 weeks of treatment.…”