title: Tumor markers in pancreatic cancer: a European Group on Tumor Markers (EGTM) status report.
abstract: Pancreatic ductal adenocarcinoma is one of the most difficult malignancies to diagnose and treat. The aim of this article is to review how tumor markers can aid the diagnosis and management of patients with this malignancy. The most widely used and best validated marker for pancreatic cancer is CA 19-9. Inadequate sensitivity and specificity limit the use of CA 19-9 in the early diagnosis of pancreatic cancer. In non-jaundiced patients, however, CA 19-9 may complement other diagnostic procedures. In patients with resectable pancreatic cancer, presurgical and postresection CA 19-9 levels correlate with overall survival. In advanced disease, elevated pretreatment levels of CA 19-9 are associated with adverse patient outcome and thus may be combined with other factors for risk stratification. Most, but not all, reports indicate that serial levels of CA 19-9 correlate with response to systemic therapy. Use of CA 19-9 kinetics in conjunction with imaging is therefore recommended in monitoring therapy. Although several potential serum and tissue markers for pancreatic cancer are currently undergoing evaluation, none are sufficiently validated for routine clinical use. CA 19-9 thus remains the serum pancreatic cancer marker against which new markers for this malignancy should be judged.
authors.affiliation: Department of Pathology and Laboratory Medicine, St Vincent's University Hospital, Dublin; UCD School of Medicine and Medical Science, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland. Electronic address: michael.j.duffy@ucd.ie.
authors.forename: M J
authors.initials: MJ
authors.lastname: Duffy
authors.affiliation: Department of Clinical Biochemistry, Royal Infirmary of Edinburgh, Edinburgh, UK.
authors.forename: C
authors.initials: C
authors.lastname: Sturgeon
authors.affiliation: Medical Klinik II, Klinikum Grosshadern, Munich, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Lamerz
authors.affiliation: Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: C
authors.initials: C
authors.lastname: Haglund
authors.affiliation: Second Department of Internal Medicine, University Hospital, Pilsen, Czech Republic.
authors.forename: V L
authors.initials: VL
authors.lastname: Holubec
authors.affiliation: Centre for Clinical and Experimental Tumour Diagnosis and Therapy, Hamburg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Klapdor
authors.affiliation: Department of Internal Medicine, University of Pisa, Pisa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Nicolini
authors.affiliation: Second Department of Internal Medicine, University Hospital, Pilsen, Czech Republic.
authors.forename: O
authors.initials: O
authors.lastname: Topolcan
authors.affiliation: Medical Clinic III, Klinikum Grosshadern, Munich, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Heinemann
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D006801:Humans; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000628:therapy
chemical_list: D014408:Biomarkers, Tumor