BACKGROUND: CA19-9 is a tumor marker for pancreatic cancer, cholangiocarcinoma, and other malignancies. However, its sensitivity and specificity is suboptimal in clinical practice, which we hypothesized limits its clinical utility. AIMS: To evaluate the clinical utility and limitations of CA19-9 as a tumor marker. METHODS: We performed a retrospective review of CA19-9 levels (U/ml) in 483 consecutive patients between 2006 and 2008 at two university hospitals. We abstracted clinical, radiographic, and pathological data and final diagnoses. Descriptive and non-parametric analyses were performed. RESULTS: Patients presenting with jaundice had the highest CA19-9 (420) compared to other complaints (<20) (p<0.01). The indications with the highest CA19-9 had evidence of biliary obstruction (71), liver mass (54), and pancreatic head mass (27) compared to other indications (<15) (p<0.01). The diagnoses with the highest CA19-9 (p<0.01) were cholangiocarcinoma (476), pancreatic cancer (161), and choledocholithiasis (138). Using a receiver operator curve to evaluate CA19-9, the area under the curve was 0.7 when evaluating all patients for pancreatic cancer or cholangiocarcinoma or patients with pancreatic head mass for pancreatic cancer. CONCLUSIONS: This study found that for pancreatic cancer and cholangiocarcinoma, CA19-9 had poor clinical utility as a tumor marker and did not change patient management. Elevations in CA19-9 were associated with biliary obstruction based on clinical history, laboratory data, and diagnoses.
BACKGROUND: CA19-9 is a tumor marker for pancreatic cancer, cholangiocarcinoma, and other malignancies. However, its sensitivity and specificity is suboptimal in clinical practice, which we hypothesized limits its clinical utility. AIMS: To evaluate the clinical utility and limitations of CA19-9 as a tumor marker. METHODS: We performed a retrospective review of CA19-9 levels (U/ml) in 483 consecutive patients between 2006 and 2008 at two university hospitals. We abstracted clinical, radiographic, and pathological data and final diagnoses. Descriptive and non-parametric analyses were performed. RESULTS:Patients presenting with jaundice had the highest CA19-9 (420) compared to other complaints (<20) (p<0.01). The indications with the highest CA19-9 had evidence of biliary obstruction (71), liver mass (54), and pancreatic head mass (27) compared to other indications (<15) (p<0.01). The diagnoses with the highest CA19-9 (p<0.01) were cholangiocarcinoma (476), pancreatic cancer (161), and choledocholithiasis (138). Using a receiver operator curve to evaluate CA19-9, the area under the curve was 0.7 when evaluating all patients for pancreatic cancer or cholangiocarcinoma or patients with pancreatic head mass for pancreatic cancer. CONCLUSIONS: This study found that for pancreatic cancer and cholangiocarcinoma, CA19-9 had poor clinical utility as a tumor marker and did not change patient management. Elevations in CA19-9 were associated with biliary obstruction based on clinical history, laboratory data, and diagnoses.
Authors: A Andriulli; T Gindro; P Piantino; R Farini; G Cavallini; L Piazzi; R Naccarato; G Dobrilla; G Verme; L A Scuro Journal: Digestion Date: 1986 Impact factor: 3.216
Authors: Marianne J van Heerde; J Buijs; B E Hansen; M de Waart; C H J van Eijck; G Kazemier; C J Pek; J W Poley; M J Bruno; E J Kuipers; H R van Buuren Journal: Dig Dis Sci Date: 2014-01-03 Impact factor: 3.199
Authors: Hari Kosanam; Ioannis Prassas; Caitlin C Chrystoja; Ireena Soleas; Alison Chan; Apostolos Dimitromanolakis; Ivan M Blasutig; Felix Rückert; Robert Gruetzmann; Christian Pilarsky; Masato Maekawa; Randall Brand; Eleftherios P Diamandis Journal: Mol Cell Proteomics Date: 2013-06-24 Impact factor: 5.911
Authors: Crystal S Seldon; Lauren E Colbert; William A Hall; Sarah B Fisher; David S Yu; Jerome C Landry Journal: World J Gastrointest Oncol Date: 2016-04-15