期刊
PANCREATOLOGY
卷 18, 期 8, 页码 971-976出版社
ELSEVIER
DOI: 10.1016/j.pan.2018.08.003
关键词
Biomarker; CA19-9; Diagnosis; Lewis antigen; Pancreatic adenocarcinoma
资金
- National Science Foundation for Distinguished Young Scholars of China [81625016]
- National Natural Science Foundation of China [81372649, 81172276, 81370065, 81372653]
- Shanghai Natural Science Foundation [17ZR1406300]
- Science and Technology Commission of Shanghai Municipality [15JC1401200]
Background: Carbohydrate antigen 19-9 (CA19-9) is the best-validated biomarker for pancreatic cancer. The National Comprehensive Cancer Network (NCCN) guideline asserts that CA19-9 will be undetectable in Lewis antigen-negative individuals. However, reports of CA19-9 secretion and its significance in Lewis (-) patients with pancreatic cancer have been inconsistent. This study was to examine serum CA19-9 levels in patients with pancreatic cancer according to Lewis status. Methods: Patients with pancreatic cancer (1482 cases) were retrieved from a prospectively maintained database. Patients with benign pancreatic disease (210 cases) and normal subjects (315 cases) were used as controls. Lewis genotypes were examined by fucosyltransferase 3 (FUT3) sequencing. Results: In patients with pancreatic cancer, 8.4% of subjects were Lewis (-), but only 41.9% of Lewis (-) subjects had CA19-9 values <= 2 U/mL. CA19-9 was even elevated (>37 U/mL) in 27.4% of Lewis (-) patients. The area under the receiver operating characteristic (ROC) curve for CA19-9 as a diagnostic biomarker was 0.842 in Lewis (-) patients with pancreatic cancer, which is closing to that of CA19-9 applied in all of patients with pancreatic cancer (0.898). Lewis (-) status was an independent prognostic factor for shorter survival in a multivariable analysis (hazard ratio (HR), 1.30, 95% confidence interval (CI), 1.03-1.64; P = 0.028). Conclusions: Not all Lewis (-) patients with pancreatic cancer are non-secretors of CA19-9. Contrary to general understanding, CA19-9 can retain its utility as a biomarker in these patients in spite of Lewis (-) genotype. (C) 2018 IAP and EPC. Published by Elsevier B.V. All rights reserved.
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