CA19-9 capability as predictor of pancreatic cancer resectability in a Spanish cohort

CA19-9 serum has been suggested as a marker of unresectability but different cut-off levels have been published. A cut-off of 500 U/ml is currently considered in an international consensus as biological criteria of borderline resectable pancreatic adenocarcinoma. To evaluate whether serum CA19-9 thr...

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Bibliographic Details
Published in:Molecular biology reports 2020-03, Vol.47 (3), p.1583-1588
Main Authors: Herreros-Villanueva, Marta, Ruiz-Rebollo, Lourdes, Montes, Mario, Rodriguez-Lopez, Mario, Francisco, María, Cubiella, Joaquín, Iyo, Eduardo, Garabitos, Emilio, Martínez Moneo, Emma, Martos, Maider, de Madaria, Enrique, Martínez-Arránz, Ibon, García-Cougil, Marta, Iglesias-Gómez, Agueda, Bujanda, Luis
Format: Article
Language:English
Subjects:
Adenocarcinoma
Adenocarcinoma - blood
Adenocarcinoma - diagnosis
Adenocarcinoma - surgery
Aged
Aged, 80 and over
Animal Anatomy
Animal Biochemistry
Biomarkers, Tumor - blood
Biomedical and Life Sciences
CA-19-9 Antigen - blood
Female
Histology
Humans
Life Sciences
Male
Mathematical models
Middle Aged
Morphology
Original Article
Pancreatic cancer
Pancreatic Neoplasms - blood
Pancreatic Neoplasms - diagnosis
Pancreatic Neoplasms - surgery
Prognosis
Prospective Studies
ROC Curve
Serum levels
Spain
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Summary:CA19-9 serum has been suggested as a marker of unresectability but different cut-off levels have been published. A cut-off of 500 U/ml is currently considered in an international consensus as biological criteria of borderline resectable pancreatic adenocarcinoma. To evaluate whether serum CA19-9 threshold of 500 U/ml could be adequate predictor of resectability in pancreatic adenocarcinoma. Multicenter, observational, prospective study performed in Spain including 203 patients diagnosed with pancreatic adenocarcinoma. 43 (21.2%) cases were resectable and 160 (78.8%) unresectable. Among the 176 preoperative CA19-9 available values, 98 (58.3%) were ≤ 500 U/ml and 73 (42.7%) > 500 U/ml. Resectability rate in those patients with CA19-9 ≤ 500 U/ml was 60% while it was found to be 18% when CA19-9 > 500 U/ml. Statistical model to predict resectability based on CA19-9 provide an AUC of 0.6618 (95% CI 0.53–0.83) when only CA19-9 values > 500 U/ml are studied. Serum levels of CA19-9 higher than 500 U/ml are indicative of unresectable disease, however reduced sensitivity and specificity lead to a limited clinical applicability for resectability.
ISSN:0301-4851
1573-4978
DOI:10.1007/s11033-020-05245-5