Abstract
CA19-9 serum has been suggested as a marker of unresectability but different cut-off levels have been published. A cut-off of 500 U/ml is currently considered in an international consensus as biological criteria of borderline resectable pancreatic adenocarcinoma. To evaluate whether serum CA19-9 threshold of 500 U/ml could be adequate predictor of resectability in pancreatic adenocarcinoma. Multicenter, observational, prospective study performed in Spain including 203 patients diagnosed with pancreatic adenocarcinoma. 43 (21.2%) cases were resectable and 160 (78.8%) unresectable. Among the 176 preoperative CA19-9 available values, 98 (58.3%) were ≤ 500 U/ml and 73 (42.7%) > 500 U/ml. Resectability rate in those patients with CA19-9 ≤ 500 U/ml was 60% while it was found to be 18% when CA19-9 > 500 U/ml. Statistical model to predict resectability based on CA19-9 provide an AUC of 0.6618 (95% CI 0.53–0.83) when only CA19-9 values > 500 U/ml are studied. Serum levels of CA19-9 higher than 500 U/ml are indicative of unresectable disease, however reduced sensitivity and specificity lead to a limited clinical applicability for resectability.
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RL and BL performed the study conception and design. RL, MM (Mario Montes), RM, FM, CJ, IE, GE, M-ME, MM (Mario Montes), DME, G-CM, I-GA and LB, participated in sample and clinical data adquisition. HM and MI performed statistical analysis. HM, BL and RL analyzed and interpreted the data, drafted and wrote the manuscript. All authors performed a critical revision and approved the manuscript.
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Supplementary Figure 1. Box plot 1. Boxplot showing CA19-9 values in no jaundice and jaundice patients (JPG 13 kb). Supplementary material 1 (DOCX 14 kb)
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Supplementary Figure 2. Receiver Operating Characteristic (ROC) curve of CA 19.9 as indicator of jaundice (JPG 15 kb). Supplementary material 1 (DOCX 16 kb)
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Herreros-Villanueva, M., Ruiz-Rebollo, L., Montes, M. et al. CA19-9 capability as predictor of pancreatic cancer resectability in a Spanish cohort. Mol Biol Rep 47, 1583–1588 (2020). https://doi.org/10.1007/s11033-020-05245-5
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DOI: https://doi.org/10.1007/s11033-020-05245-5