Tumor Biology

, Volume 35, Issue 8, pp 7459–7465 | Cite as

Diagnostic value of serum carbohydrate antigen 19-9 in pancreatic cancer: a meta-analysis

Research Article
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Abstract

Pancreatic cancer is a highly malignant cancer with increasing incidence and mortality worldwide. Carbohydrate antigen 19-9 (CA19-9) has been widely reported to play a role in the diagnosis of pancreatic cancer patients. However, published data on this subject are inconclusive. There was no meta-analysis that has been previously performed to evaluate critically the diagnostic accuracy of CA19-9 for pancreatic cancer. Therefore, we performed a meta-analysis to evaluate the sensitivity and specificity of CA19-9 in the diagnosis of pancreatic cancer. We conducted a comprehensive search to identify studies in which the pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating curves (SROC) could be determined. A total of 11 studies that included 2,316 individuals who fulfilled all of the inclusion criteria were considered for analysis. The summary estimates for serum CA19-9 in the diagnosis of pancreatic cancer in these studies were pooled sensitivity 0.80 (95 % confidence interval [CI] 0.77–0.82), specificity 0.80 (95 % CI 0.77–0.82), and DOR 14.79 (95 % CI 8.55–25.59), and the area under the curve was 0.87. Our meta-analysis showed that serum CA19-9 plays important role in the diagnosis of pancreatic cancer.

Keywords

Pancreatic cancer CA19-9 Diagnosis Meta-analysis 
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References

  1. 1.
    Maisonneuve P, Lowenfels AB. Epidemiology of pancreatic cancer: an update. Dig Dis. 2010;28:645–56.PubMedCrossRefGoogle Scholar
  2. 2.
    Bednar F, Simeone DM. Pancreatic cancer stem cell biology and its therapeutic implications. J Gastroenterol. 2011;46(12):1345–52.PubMedCrossRefGoogle Scholar
  3. 3.
    Leeflang MM, Deeks JJ, Gatsonis C, Bossuyt PM, Cochrane Diagnostic Test Accuracy Working Group. Systematic reviews of diagnostic test accuracy. Ann Intern Med. 2008;149:889–97.PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Liao Q, Zhao YP, Yang YC, et al. Combined detection of serum tumor markers for differential diagnosis of solid lesions located at the pancreatic head. Hepatobiliary Pancreat Dis Int. 2007;6:641–5.PubMedGoogle Scholar
  5. 5.
    Wu X, Lu XH, Xu T, et al. Evaluation of the diagnostic value of serum tumor markers, and fecal k-ras and p53 gene mutations for pancreatic cancer. Chin J Dig Dis. 2006;7:170–4.PubMedCrossRefGoogle Scholar
  6. 6.
    Ni XG, Bai XF, Mao YL, et al. The clinical value of serum CEA, CA19-9, and CA242 in the diagnosis and prognosis of pancreatic cancer. Eur J Surg Oncol. 2005;31:164–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Jiang JT, Wu CP, Deng HF, et al. Serum level of TSGF, CA242 and CA19-9 in pancreatic cancer. World J Gastroenterol. 2004;10:1675–7.PubMedGoogle Scholar
  8. 8.
    Jiang XT, Tao HQ, Zou SC. Detection of serum tumor markers in the diagnosis and treatment of patients with pancreatic cancer. Hepatobiliary Pancreat Dis Int. 2004;3:464–8.PubMedGoogle Scholar
  9. 9.
    Ozkan H, Kaya M, Cengiz A. Comparison of tumor marker CA 242 with CA 19-9 and carcinoembryonic antigen (CEA) in pancreatic cancer. Hepatogastroenterology. 2003;50:1669–74.PubMedGoogle Scholar
  10. 10.
    Banfi G, Bravi S, Ardemagni A, et al. CA 19.9, CA 242 and CEA in the diagnosis and follow-up of pancreatic cancer. Int J Biol Markers. 1996;11:77–81.PubMedGoogle Scholar
  11. 11.
    Haglund C, Lundin J, Kuusela P, et al. CA 242, a new tumour marker for pancreatic cancer: a comparison with CA 19-9, CA 50 and CEA. Br J Cancer. 1994;70:487–92.PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Kawa S, Tokoo M, Hasebe O, et al. Comparative study of CA242 and CA19-9 for the diagnosis of pancreatic cancer. Br J Cancer. 1994;70:481–6.PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Banfi G, Zerbi A, Pastori S, et al. Behavior of tumor markers CA19.9, CA195, CAM43, CA242, and TPS in the diagnosis and follow-up of pancreatic cancer. Clin Chem. 1993;39:420–3.PubMedGoogle Scholar
  14. 14.
    Rothlin MA, Joller H, Largiader F. CA 242 is a new tumor marker for pancreatic cancer. Cancer. 1993;71:701–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Ziske C, Schlie C, Gorschluter M, Glasmacher A, Mey U, Strehl J, et al. Prognostic value of CA 19-9 levels in patients with inoperable adenocarcinoma of the pancreas treated with gemcitabine. Br J Cancer. 2003;89:1413–7.PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Schlieman MG, Ho HS, Bold RJ. Utility of tumor markers in determining resectability of pancreatic cancer. Arch Surg. 2003;138:951–5.PubMedCrossRefGoogle Scholar
  17. 17.
    Micke O, Bruns F, Kurowski R, Horst E, deVries AF, Hausler JW, et al. Predictive value of carbohydrate antigen 19-9 in pancreatic cancer treated with radiochemotherapy. Int J Radiat Oncol Biol Phys. 2003;57:90–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Magnani JL. The discovery, biology, and drug development of sialyl Lea and sialyl Lex. Arch Biochem Biophys. 2004;426:122–31.PubMedCrossRefGoogle Scholar
  19. 19.
    Levy C, Lymp J, Angulo P, Gores GJ, Larusso N, Lindor KD. The value of serum CA 19-9 in predicting cholangiocarcinomas in patients with primary sclerosing cholangitis. Dig Dis Sci. 2005;50:1734–40.PubMedCrossRefGoogle Scholar
  20. 20.
    Nazli O, Bozdag AD, Tansug T, Kir R, Kaymak E. The diagnostic importance of CEA and CA 19-9 for the early diagnosis of pancreatic carcinoma. Hepatogastroenterology. 2000;47:1750–2.PubMedGoogle Scholar
  21. 21.
    Mazurek S, Boschek CB, Hugo F, Eigenbrodt E. Pyruvate kinase type M2 and its role in tumor growth and spreading. Semin Cancer Biol. 2005;15:300–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Ventrucci M, Cipolla A, Racchini C, Casadei R, Simoni P, Gullo L. Tumor M2-pyruvate kinase, a new metabolic marker for pancreatic cancer. Dig Dis Sci. 2004;49:1149–55.PubMedCrossRefGoogle Scholar
  23. 23.
    Goggins M. Molecular markers of early pancreatic cancer. J Clin Oncol. 2005;23:4524–31.PubMedCrossRefGoogle Scholar
  24. 24.
    Koopmann J, Buckhaults P, Brown DA, Zahurak ML, Sato N, Fukushima N, et al. Serum macrophage inhibitory cytokine 1 as a marker of pancreatic and other periampullary cancers. Clin Cancer Res. 2004;10:2386–92.PubMedCrossRefGoogle Scholar
  25. 25.
    Koopmann J, White CN, Zhang Z, Canto MI, Brown DA, Hunter M, et al. Serum markers in patients with respectable pancreatic adenocarcinoma: MIC-1 vs. CA19-9. Clin Cancer Res. 2006;12:442–6.PubMedCrossRefGoogle Scholar
  26. 26.
    Yamaguchi K, Enjoji M, Nakashima M, Nakamuta M, Watanabe T, Tanaka M. Novel serum tumor marker, RCAS1, in pancreatic diseases. World J Gastroenterol. 2005;11:5199–202.PubMedGoogle Scholar
  27. 27.
    Kolb A, Kleeff J, Guweidhi A, Esposito I, Giese NA, Adwan H, et al. Osteopontin influences the invasiveness of pancreatic cancer cells and is increased in neoplastic and inflammatory conditions. Cancer Biol Ther. 2005;4:740–6.PubMedCrossRefGoogle Scholar
  28. 28.
    Koopmann J, Fedarko NS, Jain A, Maitra A, Iacobuzio-Donahue C, Rahman A, et al. Evaluation of osteopontin as biomarker for pancreatic adenocarcinoma. Cancer Epidemiol Biomarkers Prev. 2004;13:487–91.PubMedGoogle Scholar
  29. 29.
    Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PM. The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol. 2003;56(11):1129–35.PubMedCrossRefGoogle Scholar
  30. 30.
    Jones CM, Athanasiou T. Summary receiver operating characteristic curve analysis techniques in the evaluation of diagnostic tests. Ann Thorac Surg. 2005;79:16–20.PubMedCrossRefGoogle Scholar
  31. 31.
    Walter SD. Properties of the summary receiver operating characteristic (SROC) curve for diagnostic test data. Stat Med. 2002;21:1237–56.PubMedCrossRefGoogle Scholar

Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2014

Authors and Affiliations

  1. 1.Department of GastroenterologyLiaoning Cancer Hospital and InstituteShenyangChina

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