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New observations on the utility of CA19-9 as a biomarker in Lewis negative patients with pancreatic cancer
- Source :
- Pancreatology. 18:971-976
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Background Carbohydrate antigen 19-9 (CA19-9) is the best-validated biomarker for pancreatic cancer. The National Comprehensive Cancer Network (NCCN) guideline asserts that “CA19-9 will be undetectable in Lewis antigen-negative individuals”. However, reports of CA19-9 secretion and its significance in Lewis (-) patients with pancreatic cancer have been inconsistent. This study was to examine serum CA19-9 levels in patients with pancreatic cancer according to Lewis status. Methods Patients with pancreatic cancer (1482 cases) were retrieved from a prospectively maintained database. Patients with benign pancreatic disease (210 cases) and normal subjects (315 cases) were used as controls. Lewis genotypes were examined by fucosyltransferase 3 (FUT3) sequencing. Results In patients with pancreatic cancer, 8.4% of subjects were Lewis (-), but only 41.9% of Lewis (-) subjects had CA19-9 values ≤ 2 U/mL. CA19-9 was even elevated (>37 U/mL) in 27.4% of Lewis (-) patients. The area under the receiver operating characteristic (ROC) curve for CA19-9 as a diagnostic biomarker was 0.842 in Lewis (-) patients with pancreatic cancer, which is closing to that of CA19-9 applied in all of patients with pancreatic cancer (0.898). Lewis (-) status was an independent prognostic factor for shorter survival in a multivariable analysis (hazard ratio (HR), 1.30, 95% confidence interval (CI), 1.03–1.64; P = 0.028). Conclusions Not all Lewis (-) patients with pancreatic cancer are non-secretors of CA19-9. Contrary to general understanding, CA19-9 can retain its utility as a biomarker in these patients in spite of Lewis (-) genotype.
- Subjects :
- Male
medicine.medical_specialty
Pancreatic disease
CA-19-9 Antigen
Genotype
endocrine system diseases
Endocrinology, Diabetes and Metabolism
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Pancreatic cancer
Internal medicine
Biomarkers, Tumor
medicine
Humans
Aged
Hepatology
Receiver operating characteristic
business.industry
Hazard ratio
Pancreatic Diseases
Cancer
Middle Aged
Fucosyltransferases
medicine.disease
Survival Analysis
digestive system diseases
Pancreatic Neoplasms
030220 oncology & carcinogenesis
Biomarker (medicine)
Female
030211 gastroenterology & hepatology
CA19-9
business
Subjects
Details
- ISSN :
- 14243903
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- Pancreatology
- Accession number :
- edsair.doi.dedup.....2c7dd985c4fc05a973a9804a7c3b3a2d