Skip to main content

Advertisement

SpringerLink
Log in

CA125 is Superior to CA19-9 in Predicting the Resectability of Pancreatic Cancer

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Although carbohydrate antigen 19-9 (CA19-9) has been reported as a biomarker to predict the resectability of pancreatic cancer, several limitations have restricted its clinical use.

Methods

The potential of several serum tumor markers (CA19-9, CA125, CA50, CA242, CA724, carcinoembryonic antigen (CEA), and alpha-fetoprotein (AFP)) to predict the resectability of pancreatic cancer was evaluated by receiver operating characteristic (ROC) analysis in a series of 212 patients with proven pancreatic cancer.

Results

Compared with other tumor markers including CA19-9, CA125 has a superior predictive value (CA19-9, ROC area 0.66, cutoff value 289.40 U/mL; CA125, ROC area 0.81, cutoff value 19.70 U/mL). In addition, for patients with unresectable diseases misjudged by CT as resectable, the percentage of CA125 over selected cutoff value was higher than that of CA19-9 (CA19-9, 70.27 %; CA125, 81.08 %).

Conclusion

CA125 is superior to CA19-9 in predicting the resectability of pancreatic cancer. Aberrant high levels of CA125 may indicate unresectable pancreatic cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin 2010; 60:277–300.

    Article  PubMed  Google Scholar 

  2. Winter JM, Cameron JL, Campbell KA, Arnold MA, Chang DC, Coleman J, Hodgin MB, Sauter PK, Hruban RH, Riall TS, Schulick RD, Choti MA, Lillemoe KD, Yeo CJ. 1423 pancreaticoduodenectomies for pancreatic cancer: A single-institution experience. J Gastrointest Surg 2006; 10:1199–1210.

    Article  PubMed  Google Scholar 

  3. Parsons CM, Sutcliffe JL, Bold RJ. Preoperative evaluation of pancreatic adenocarcinoma. J Hepatobiliary Pancreat Surg 2008; 15:429–435.

    Article  PubMed  Google Scholar 

  4. Michalski CW, Kleeff J, Bachmann J, Alkhatib J, Erkan M, Esposito I, Hinz U, Friess H, Buchler MW. Second-look operation for unresectable pancreatic ductal adenocarcinoma at a high-volume center. Ann Surg Oncol 2008; 15:186–192.

    Article  PubMed  Google Scholar 

  5. Callery MP, Chang KJ, Fishman EK, Talamonti MS, William Traverso L, Linehan DC. Pretreatment assessment of resectable and borderline resectable pancreatic cancer: expert consensus statement. Ann Surg Oncol 2009; 16:1727–1733.

    Article  PubMed  Google Scholar 

  6. Vargas R, Nino-Murcia M, Trueblood W, Jeffrey RB, Jr. MDCT in Pancreatic adenocarcinoma: prediction of vascular invasion and resectability using a multiphasic technique with curved planar reformations. AJR Am J Roentgenol 2004; 182:419–425.

    Article  PubMed  Google Scholar 

  7. Diehl SJ, Lehmann KJ, Sadick M, Lachmann R, Georgi M. Pancreatic cancer: value of dual-phase helical CT in assessing resectability. Radiology 1998; 206:373–378.

    PubMed  CAS  Google Scholar 

  8. Valls C, Andia E, Sanchez A, Fabregat J, Pozuelo O, Quintero JC, Serrano T, Garcia-Borobia F, Jorba R. Dual-phase helical CT of pancreatic adenocarcinoma: assessment of resectability before surgery. AJR Am J Roentgenol 2002; 178:821–826.

    Article  PubMed  Google Scholar 

  9. Kim YC, Kim HJ, Park JH, Park DI, Cho YK, Sohn CI, Jeon WK, Kim BI, Shin JH. Can preoperative CA19-9 and CEA levels predict the resectability of patients with pancreatic adenocarcinoma? J Gastroenterol Hepatol 2009; 24:1869–1875.

    Article  PubMed  CAS  Google Scholar 

  10. Forsmark CE, Lambiase L, Vogel SB. Diagnosis of pancreatic cancer and prediction of unresectability using the tumor-associated antigen CA19-9. Pancreas 1994; 9:731–734.

    Article  PubMed  CAS  Google Scholar 

  11. Fujioka S, Misawa T, Okamoto T, Gocho T, Futagawa Y, Ishida Y, Yanaga K. Preoperative serum carcinoembryonic antigen and carbohydrate antigen 19-9 levels for the evaluation of curability and resectability in patients with pancreatic adenocarcinoma. J Hepatobiliary Pancreat Surg 2007; 14:539–544.

    Article  PubMed  Google Scholar 

  12. Bunger S, Laubert T, Roblick UJ, Habermann JK. Serum biomarkers for improved diagnostic of pancreatic cancer: a current overview. J Cancer Res Clin Oncol 2011; 137:375–389.

    Article  PubMed  CAS  Google Scholar 

  13. Maithel SK, Maloney S, Winston C, Gonen M, D'Angelica MI, Dematteo RP, Jarnagin WR, Brennan MF, Allen PJ. Preoperative CA 19-9 and the yield of staging laparoscopy in patients with radiographically resectable pancreatic adenocarcinoma. Ann Surg Oncol 2008; 15:3512–3520.

    Article  PubMed  Google Scholar 

  14. Schlieman MG, Ho HS, Bold RJ. Utility of tumor markers in determining resectability of pancreatic cancer. Arch Surg 2003; 138:951–955.

    Article  PubMed  Google Scholar 

  15. Marrelli D, Caruso S, Pedrazzani C, Neri A, Fernandes E, Marini M, Pinto E, Roviello F. CA19-9 serum levels in obstructive jaundice: clinical value in benign and malignant conditions. Am J Surg 2009; 198:333–339.

    Article  PubMed  CAS  Google Scholar 

  16. Tempero MA, Uchida E, Takasaki H, Burnett DA, Steplewski Z, Pour PM. Relationship of carbohydrate antigen 19-9 and Lewis antigens in pancreatic cancer. Cancer Res 1987; 47:5501–5503.

    PubMed  CAS  Google Scholar 

  17. Haglund C. Tumour marker antigen CA125 in pancreatic cancer: a comparison with CA19-9 and CEA. Br J Cancer 1986; 54:897–901.

    Article  PubMed  CAS  Google Scholar 

  18. Duraker N, Hot S, Polat Y, Hobek A, Gencler N, Urhan N. CEA, CA 19-9, and CA 125 in the differential diagnosis of benign and malignant pancreatic diseases with or without jaundice. J Surg Oncol 2007; 95:142–147.

    Article  PubMed  CAS  Google Scholar 

  19. Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 2010; 17:1471–1474.

    Article  PubMed  Google Scholar 

  20. Ferrone CR, Finkelstein DM, Thayer SP, Muzikansky A, Fernandez-delCastillo C, Warshaw AL. Perioperative CA19-9 levels can predict stage and survival in patients with resectable pancreatic adenocarcinoma. J Clin Oncol 2006; 24:2897–2902.

    Article  PubMed  CAS  Google Scholar 

  21. Yeo CJ, Cameron JL, Lillemoe KD, Sitzmann JV, Hruban RH, Goodman SN, Dooley WC, Coleman J, Pitt HA. Pancreaticoduodenectomy for cancer of the head of the pancreas. 201 patients. Ann Surg 1995; 221:721–731.

    Article  PubMed  CAS  Google Scholar 

  22. Rosch T, Dittler HJ, Strobel K, Meining A, Schusdziarra V, Lorenz R, Allescher HD, Kassem AM, Gerhardt P, Siewert JR, Hofler H, Classen M. Endoscopic ultrasound criteria for vascular invasion in the staging of cancer of the head of the pancreas: a blind reevaluation of videotapes. Gastrointest Endosc 2000; 52:469–477.

    Article  PubMed  CAS  Google Scholar 

  23. Koprowski H, Herlyn M, Steplewski Z, Sears HF. Specific antigen in serum of patients with colon carcinoma. Science 1981; 212:53–55.

    Article  PubMed  CAS  Google Scholar 

  24. Yin BW, Dnistrian A, Lloyd KO. Ovarian cancer antigen CA125 is encoded by the MUC16 mucin gene. Int J Cancer 2002; 98:737–740.

    Article  PubMed  CAS  Google Scholar 

  25. Canney PA, Moore M, Wilkinson PM, James RD. Ovarian cancer antigen CA125: a prospective clinical assessment of its role as a tumour marker. Br J Cancer 1984; 50:765–769.

    Article  PubMed  CAS  Google Scholar 

  26. Cwik G, Wallner G, Skoczylas T, Ciechanski A, Zinkiewicz K. Cancer antigens 19-9 and 125 in the differential diagnosis of pancreatic mass lesions. Arch Surg 2006; 141:968–973.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Dr. Jingjing Feng and Dr. Kefu Liu for their expert technical assistance. This study was supported in part by the Sino-German Center (GZ857), by the Science Foundation of Shanghai (13ZR1407500), and by the National Science Foundation of China (grant nos. 81101807, 81001058, 81372649, 81372653, and 81172276).

Conflict of Interest

The authors indicated no potential conflicts of interest.

Author information

Authors and Affiliations

  1. Pancreatic Cancer Institute, Fudan University, No. 270, Dong’An Road, Xuhui District, Shanghai, 200032, China

    Guopei Luo, Zhiwen Xiao, Jiang Long, Zuqiang Liu, Liang Liu, Chen Liu, Jin Xu, Quanxing Ni & Xianjun Yu

  2. Department of Pancreas & Hepatobiliary Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China, 200032

    Guopei Luo, Zhiwen Xiao, Jiang Long, Zuqiang Liu, Liang Liu, Chen Liu, Jin Xu, Quanxing Ni & Xianjun Yu

  3. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China, 200032

    Guopei Luo, Zhiwen Xiao, Jiang Long, Zuqiang Liu, Liang Liu, Chen Liu, Jin Xu, Quanxing Ni & Xianjun Yu

Authors
  1. Guopei Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhiwen Xiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jiang Long
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zuqiang Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Liang Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chen Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jin Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Quanxing Ni
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Xianjun Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xianjun Yu.

Additional information

Guopei Luo, Zhiwen Xiao, and Jiang Long have equal contribution.

The paper is not based on a previous communication to a society or meeting.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Luo, G., Xiao, Z., Long, J. et al. CA125 is Superior to CA19-9 in Predicting the Resectability of Pancreatic Cancer. J Gastrointest Surg 17, 2092–2098 (2013). https://doi.org/10.1007/s11605-013-2389-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-013-2389-9

Keywords

Search

Navigation