Serum CA 19-9 and CEA Levels as a Prognostic Factor in Pancreatic Adenocarcinoma
0
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Purpose: To investigate the use of pretreatment carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) as prognostic factors to determine survival in pancreatic adenocarcinoma. Materials and Methods: A retrospective review of the medical records of patients who were diagnosed with pancreatic adenocarcinoma and received surgery, chemoradiotherapy or chemotherapy was performed. Factors, including CA 19-9 and CEA, associated with the survival of pancreatic cancer patients were analyzed. Results: Patients with the median age of 65 years were included (n=187). Elevated serum CA 19-9 levels and CEA levels were observed in 75.4% and 39% of patients at diagnosis, respectively. CEA was correlated with tumor stages (p=0.005), but CA 19-9 was not. CA 19-9 and CEA were elevated in 69.0% and 33.3% of patients with resectable pancreatic cancer, and elevated in 72.9% and 47.2% of patients with advanced pancreatic cancer, respectively. The median overall survival of the normal serum CEA group was longer than that of the elevated serum CEA group (16.3 months vs. 10.2 months, p=0.004). However, the median overall survival of the normal serum CA 19-9 group was not different from that of the elevated serum CA 19-9 group (12.4 months vs. 13.5 months, p=0.969). The independent factors associated with overall survival were advanced pancreatic cancer [harzard ratio (HR) 4.33, p=0.001] and elevated serum CEA level (HR 1.52, p=0.032). Conclusion: Patients with elevated serum CEA level at diagnosis demonstrated poor overall survival. Pretreatment CEA level may predict the prognosis of patients with pancreatic adenocarcinoma.
Abstract
Purpose: To investigate the use of pretreatment carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) as prognostic factors to determine survival in pancreatic adenocarcinoma. Materials and Methods: A retrospective review of the medical records of patients who were diagnosed with pancreatic adenocarcinoma and received surgery, chemoradiotherapy or chemotherapy was performed. Factors, including CA 19-9 and CEA, associated with the survival of pancreatic cancer patients were analyzed. Results: Patients with the median age of 65 years were included (n=187). Elevated serum CA 19-9 levels and CEA levels were observed in 75.4% and 39% of patients at diagnosis, respectively. CEA was correlated with tumor stages (p=0.005), but CA 19-9 was not. CA 19-9 and CEA were elevated in 69.0% and 33.3% of patients with resectable pancreatic cancer, and elevated in 72.9% and 47.2% of patients with advanced pancreatic cancer, respectively. The median overall survival of the normal serum CEA group was longer than that of the elevated serum CEA group (16.3 months vs. 10.2 months, p=0.004). However, the median overall survival of the normal serum CA 19-9 group was not different from that of the elevated serum CA 19-9 group (12.4 months vs. 13.5 months, p=0.969). The independent factors associated with overall survival were advanced pancreatic cancer [harzard ratio (HR) 4.33, p=0.001] and elevated serum CEA level (HR 1.52, p=0.032). Conclusion: Patients with elevated serum CEA level at diagnosis demonstrated poor overall survival. Pretreatment CEA level may predict the prognosis of patients with pancreatic adenocarcinoma.
참고문헌 (27)
- Siegel R, "Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths", CA Cancer J Clin, 61, pp.212~236 (2011)
- Winek T, "Prognostic factors for survival after pancreaticoduodenectomy for malignant disease", Am J Surg, 159, pp.454~456 (1990)
- Michaud DS, "Epidemiology of pancreatic cancer", Minerva Chir, 59, pp.99~111 (2004)
- Bünger S, "Serum biomarkers for improved diagnostic of pancreatic cancer: a current overview", J Cancer Res Clin Oncol, 137, pp.375~389 (2011)
- Carriquiry LA, "Should carcinoembryonic antigen be used in the management of patients with colorectal cancer?", Dis Colon Rectum, 42, pp.921~929 (1999)
- Kim YC, "Can preoperative CA 19-9 and CEA levels predict the resectability of patients with pancreatic adenocarcinoma?", J Gastroenterol Hepatol, 24, pp.1869~1875 (2009)
- Saad ED, "Pretreatment CA 19-9 level as a prognostic factor in patients with advanced pancreatic cancer treated with gemcitabine", Int J Gastrointest Cancer, 32, pp.35~41 (2002)
- Hess V, "CA 19-9 tumour-marker response to chemotherapy in patients with advanced pancreatic cancer enrolled in a randomised controlled trial", Lancet Oncol, 9, pp.132~138 (2008)
- Pyun HO, "CA 19-9 AS A PREDICTOR FOR RESPONSE AND SURVIVAL IN ADVANCED PANCREATIC CANCER PATIENTS TREATED WITH CHEMORADIOTHERAPY", INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 73(4), pp.1148~1154 (2009), Elsevier BV
- Koprowski H, "Specific antigen in serum of patients with colon carcinoma", Science, 212, pp.53~55 (1981)
- Halloran CM, "Carbohydrate antigen 19.9 accurately selects patients for laparoscopic assessment to determine resectability of pancreatic malignancy", Br J Surg, 95, pp.453~459 (2008)
- Mehta J, "Evaluating the efficacy of tumor markers CA 19-9 and CEA to predict operability and survival in pancreatic malignancies", Trop Gastroenterol, 31, pp.190~194 (2010)
- Berger AC, "Postresection CA 19-9 predicts overall survival in patients with pancreatic cancer treated with adjuvant chemoradiation: a prospective validation by RTOG 9704", J Clin Oncol, 26, pp.5918~5922 (2008)
- Gold P, "Demonstration of tumor-specific antigens in human colonic carcinomata by immunological tolerance and absorption techniques", J Exp Med, 121, pp.439~462 (1965)
- Yasue M, "Prognostic values of preoperative and postoperative CEA and CA19.9 levels in pancreatic cancer", Pancreas, 9, pp.735~740 (1994)
- Kalser MH, "Circulating carcinoembryonic antigen in pancreatic carcinoma", Cancer, 42(3), pp.1468~1471 (1978)
- Taylor OM, "The prognostic value of the tumour markers CA 195 and CEA in patients with adenocarcinoma of the pancreas", Eur J Surg Oncol, 18, pp.508~513 (1992)
- Tempero MA, "Relationship of carbohydrate antigen 19-9 and Lewis antigens in pancreatic cancer", Cancer Res, 47, pp.5501~5503 (1987)
- Goonetilleke KS, "Systematic review of carbohydrate antigen (CA 19-9) as a biochemical marker in the diagnosis of pancreatic cancer", Eur J Surg Oncol, 33, pp.266~270 (2007)
- Ni XG, "The clinical value of serum CEA, CA 19-9, and CA242 in the diagnosis and prognosis of pancreatic cancer", Eur J Surg Oncol, 31, pp.164~169 (2005)
- Peterli R, "CA 19-9 has no value as a tumor marker in obstructive jaundice", Schweiz Med Wochenschr, 129, pp.77~79 (1999)
- Molina R, "Evaluation of tumor markers (HER-2", neu oncoprotein, CEA, and CA 15.3) in patients with locoregional breast cancer: prognostic value, 2010, pp.31, 171~180
- Borras G, "Tumor antigens CA 19.9, CA 125, and CEA in carcinoma of the uterine cervix", Gynecol Oncol, 57, pp.205~211 (1995)
- Grunnet M, "Carcinoembryonic antigen (CEA) as tumor marker in lung cancer", Lung Cancer, 76, pp.138~143 (2012)
- Benchimol S, "Carcinoembryonic antigen, a human tumor marker, functions as an intercellular adhesion molecule", Cell, 57, pp.327~334 (1989)
- Kaufman HL, "Combination chemotherapy and ALVAC-CEA", B7.1 vaccine in patients with metastatic colorectal cancer, 2008, pp.14, 4843~4849
- Gulley JL, "A pilot safety trial investigating a vector-based vaccine targeting carcinoembryonic antigen in combination with radiotherapy in patients with gastrointestinal malignancies metastatic to the liver", Expert Opin Biol Ther, 11, pp.1409~1418 (2011)