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Evaluation of CA 242 as a Tumor Marker in Gallbladder Cancer

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Abstract

Purpose

Gallbladder and pancreas share common embryological origin, and malignancies of these organs may share common tumor antigens. CA 242 is a tumor marker for pancreatic cancer, but has not been studied in gallbladder cancer (GBC). We measured serum CA 242 levels in patients with GBC and compared it with those in patients with gallstones (GS) and healthy volunteers.

Methods

We enrolled consecutive patients with GBC (cases), GS (disease controls), and healthy volunteers (healthy controls). Serum CA 242, CEA, and CA 19–9 levels were measured using ELISA. Receiver operator curve was plotted for all the three markers.

Results

We studied 117 patients with GBC, 58 with GS, and 10 healthy volunteers. Among patients with GBC, 81 (69%) also had GB calculi. Patients with GBC more often had elevated CA 242 levels (64%) compared to those with GS (17%; p < 0.001) and healthy controls (0%; p < 0.001). The median levels of CA 242 was higher in the GBC group (59 [199] U/ml) compared to the GS group (10 [13] U/ml; p < 0.001) and the control group (3 [14.5] U/ml; p < 0.001). The sensitivity, specificity, positive predictive value (PPV), and negative predictive values of CA 242 for diagnosis of GBC were 64%, 83%, 88%, and 53%, respectively. At a cutoff of 45 U/ml, the specificity and PPV increased to 100%. CA 242 had higher AOC (0.759) compared to CEA (0.528) and CA 19–9 (0.430).

Conclusions

CA 242 is a promising tumor marker for GBC and performs better than CEA and CA 19-9.

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References

  1. Zatonski WA, Lowenfields AB, Boyle P, et al. Epidemiologic aspects of gallbladder cancer: a case controlled study of the Search Programme of the International Agency for Research on Cancer. J Natl Cancer Inst. 1997;89:1132–8.

    Article  PubMed  CAS  Google Scholar 

  2. Parkin DM, Muir CS, Whelan SL, GAo YT, Ferlay J, Powells J (eds). (1992) Cancer incidence in 5 continents. Vol VI. IARC Scientific publications NO 120. Lyon: IARC

  3. ICMR National Cancer Registry Program, Biennial Report 1988–89. An epidemiological study. New Delhi: ICMR; 1992. p. 14–5.

    Google Scholar 

  4. Kapoor VK, McMichael AJ. Gallbladder cancer: an Indian disease. Natl Med J India. 2003;16:209–13.

    PubMed  CAS  Google Scholar 

  5. Rothlin MA, Joller H, Largiader F. CA 242 is a new tumor marker for pancreatic cancer. Cancer. 1993;71:701–7.

    Article  PubMed  CAS  Google Scholar 

  6. Haglund C, Lundin J, Kuusela P, Roberts PJ. 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.

    Article  PubMed  CAS  Google Scholar 

  7. Pasanen PA, Eskelinen M, Partanen K, Pikkarainen P, Penttila I, Alhava E. Clinical evaluation of a new serum tumour marker CA 242 in pancreatic carcinoma. Br J Cancer. 1992;65:731–4.

    Article  PubMed  CAS  Google Scholar 

  8. 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.

    PubMed  Google Scholar 

  9. Strom BL, Maislin G, West SL, et al. Serum CEA and CA 19–9: potential future diagnostic or screening tests for gallbladder cancer? Int J Cancer. 1990;45:821–4.

    Article  PubMed  CAS  Google Scholar 

  10. Del Favero G, Fabris C, Panucci A, Basso D, Plebani M, Baccaglini U, et al. Carbohydrate antigen 19–9 (CA 19–9) and carcinoembryonic antigen (CEA) in pancreatic cancer. Role of age and liver dysfunction. Bull Cancer. 1986;73:251–5.

    PubMed  Google Scholar 

  11. Engaras B, Hafstrom L, Kewenter J, Nilsson O, Wedel H. Standard serum concentrations and normal fluctuations of CEA, CA 50 and CA 242 during twelve months in men and women aged 60–64 years without malignant disease. Eur J Surg. 1999;165:110–6.

    Article  PubMed  CAS  Google Scholar 

  12. Henson DE, Albores-Saavedra J, Corle D. Carcinoma of the gallbladder. Histologic types, stage of the disease, grade and survival rates. Cancer. 1992;70:1493–7.

    Article  PubMed  CAS  Google Scholar 

  13. Dixon E, Vollmer Jr CM, Sahajpal A, et al. An aggressive surgical approach leads to improved survival in patients with gallbladder cancer: a 12-year study at a North American Center. Ann Surg. 2005;241:385–94.

    Article  PubMed  Google Scholar 

  14. Batra Y, Pal S, Dutta U, et al. Gallbladder cancer in India: a dismal picture. J Gastroenterol Hepatol. 2005;20:309–14.

    Article  PubMed  Google Scholar 

  15. Park JS, Oh SY, Kim SH, Kwon HC, Kim JS, Jin-Kim H, et al. Single-agent gemcitabine in the treatment of advanced biliary tract cancers: a phase II study. Jpn J Clin Oncol. 2005;35:68–73.

    Article  PubMed  Google Scholar 

  16. Thongprasert S, Napapan S, Charoentum C, Moonprakan S. Phase II study of gemcitabine and cisplatin as first-line chemotherapy in inoperable biliary tract carcinoma. Ann Oncol. 2005;16:279–81.

    Article  PubMed  CAS  Google Scholar 

  17. Pasanen PA, Eskelinen M, Partanen K, Pikkarainen P, Penttila I, Alhava E. Receiver operating characteristic (ROC) curve analysis of the tumour markers CEA, CA 50 and CA 242 in pancreatic cancer: results from a prospective study. Br J Cancer. 1993;67:852–5.

    Article  PubMed  CAS  Google Scholar 

  18. Dutta U, Garg PK, Kumar R, Tandon RK. Typhoid carriers among patients with gallstones are at increased risk for carcinoma of the gallbladder. Am J Gastroenterol. 2000;95:784–7.

    Article  PubMed  CAS  Google Scholar 

  19. Kim SB, Fernandes LC, Saad SS, Matos D. Assessment of the value of preoperative serum levels of CA 242 and CEA in the staging and postoperative survival of colorectal adenocarcinoma patients. Int J Biol Markers. 2003;18:182–7.

    PubMed  CAS  Google Scholar 

  20. Dutta U, Nagi B, Garg PK, Sinha SK, Singh K, Tandon RK. Patients with gallstones develop gallbladder cancer at an earlier age. Eur J Cancer Prev. 2005;14:381–5.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Usha Dutta.

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Rana, S., Dutta, U., Kochhar, R. et al. Evaluation of CA 242 as a Tumor Marker in Gallbladder Cancer. J Gastrointest Canc 43, 267–271 (2012). https://doi.org/10.1007/s12029-011-9288-7

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