Increased levels of both carbohydrate antigen 19-9 and duke pancreatic monoclonal antigen type 2 reflect postoperative prognosis in patients with pancreatic carcinoma.
OBJECTIVE
It is important to identify useful tumor markers for the prediction of postoperative outcomes in patients with pancreatic carcinoma (PC).


METHODS
A retrospective study was performed in 87 patients who underwent surgical resection for PC. Preoperative levels of tumor markers such as carbohydrate antigen 19-9 (CA19-9) and duke pancreatic monoclonal antigen type 2 (DUPAN-2) were estimated and analyzed in relation to disease-specific survival (DSS).


RESULTS
The CA19-9 level did not correlate with the DUPAN-2 level (R=-0.057). Prognosis correlated with CA19-9 levels, and patients with 185 U/mL or lower CA19-9 level showed significantly better DSS than patients with 186-U/mL or higher CA19-9 level (P=0.015). Patients with 151- to 800-U/mL DUPAN-2 level showed significantly worse DSS than patients with 801-U/mL or higher DUPAN-2 level (P=0.0023), so the prognosis was reversely related to the DUPAN-2 level. Patients with increased levels of both CA19-9 and DUPAN-2 showed significantly worse DSS than the patients without elevated levels (P<or=0.0023). The independent predictors of poor DSS (hazards ratio, 95% confidence interval) were the following: non-well-differentiated adenocarcinoma (2.35, 1.28-4.53), invasion of the portal vein (2.57, 1.47-4.47), and increased levels of both CA19-9 and DUPAN-2 (3.01, 1.72-5.32).


CONCLUSIONS
The increased levels of both CA19-9 and DUPAN-2 closely reflect prognosis in patients with PC.
Department of Gastroenterological Surgery, Oita University Faculty of Medicine, Oita, Japan. shibatakohei@med.oita-u.ac.jp
Kohei
K
Shibata
Kentaro
K
Iwaki
Seiichiro
S
Kai
Masayuki
M
Ohta
Seigo
S
Kitano
D000230:Adenocarcinoma / Q000097:blood / Q000276:immunology / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; C042317:DU-PAN-2 antigen, human