Is CA19-9 a good marker of pancreatic cancer?

The prognosis of pancreatic cancer is extremely poor and early diagnosis is difficult. At the time of diagnosis, local vascular involvement, nodal and distant metastases are frequently present. Currently, the best way of preoperative staging of pancreatic cancer is bolus-contrast, triple-phase helical computed tomography. However, the positive predictive value of the test is low, and approximately 25%-50% of patients predicted to have resectable disease on computed tomography turn out to have unresectable lesions at laparotomy. CA19-9 is the most widely used pancreatic cancer serum markers. Its level has been shown to correlate with the TNM staging and the tumor sizes in patients with pancreatic cancer. But little is known about the value of serum CA19-9 levels in evaluating respectability of pancreatic carcinoma.

A research article to be published on 21 June 2008, in the World Journal of Gastroenterology addresses this question. The research team led by Prof. Zhang from Department of Hepatobiliary Surgery in Affiliated Hospital of medical college of Qingdao University had retrospectivly studied the clinical data of 104 patients to evaluate the clinical value of serum CA19-9 levels in predicting respectability of pancreatic carcinoma according to receiver operating characteristic (ROC) curve analysis.

They found that the area under the ROC curve was 0.918, 95% CI were 0.843-0.992; The left-hand corner cut-off CA19-9 level is 353.15 U/mL, the sensitivity and specificity was 93.1% and 78.3% respectively; Positive and negative predictive values was 84.38% and 90% according to this level. According to statistic principle, preoperative serum CA 19-9 level is a useful marker for evaluating respectability of pancreatic cancer. Obviously increased serum levels of CA19-9 can be regarded as the ancillary parameter for the unresectable pancreatic cancer. These will increase the accurate of predicting respectability of pancreatic carcinoma and avoid unnecessary laparotomy.

Reference: Zhang S, Wang YM, Sun CD, Lu Y, Wu LQ. Clinical value of serum CA19-9 levels in evaluating respectability of pancreatic carcinoma. World J Gastroenterol 2008; 14(23): 3750-3753
http://www.wjgnet.com/1007-9327/14/3750.asp

Correspondence to: Zhang Shun, Department of Hepato-biliary Surgery, Affiliated Hospital of Medical College, Qingdao University, No.16 Jiangsu Rd. Qingdao 266003, Shandong Province, China. wym0066@sina.com
Telephone: +86-532-82911369 Fax: +86-532-82911999

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

The WJG Press mainly publishes World Journal of Gastroenterology.