title: Serum levels of LDH, CEA, and CA19-9 have prognostic roles on survival in patients with metastatic pancreatic cancer receiving gemcitabine-based chemotherapy.
abstract: OBJECTIVE
  Serum LDH, CEA, and CA19-9 levels are important tumor markers in pancreatic cancer. The purpose of this study was to evaluate the clinical significance of serum LDH, CEA, and CA19-9 levels in metastatic pancreatic cancer (MPC) receiving gemcitabine-based chemotherapy.
  
  
  METHODS
  In this retrospective study, we analyzed the outcome of 196 MPC patients who are treated with gemcitabine-based chemotherapy in our clinic.
  
  
  RESULTS
  Positivity rates of serum LDH, CEA, and CA19-9 were 22, 40, and 83 %, respectively. Likewise, the rates of very high serum levels of tumor markers were correlated with these positivity rates (9 % for LDH, 30 % for CEA, and 55 % for CA19-9). The serum LDH levels were significantly higher in older patients (p = 0.05) and also in the patients with large tumors (p = 0.05), hepatic metastasis (p = 0.01), hypoalbuminemia (p = 0.01), and unresponsive to chemotherapy (p = 0.04). However, no correlation was found between both serum CEA and CA19-9 levels and possible prognostic factors (p > 0.05). The significant relationships were found between the serum levels of CEA and CA19-9 (r s = 0.24, p = 0.004), and serum LDH and CEA (r(s) = 0.193, p = 0.02). But, there was no correlation between serum LDH and CA19-9 levels (p = 0.39). One-year overall survival rate was 12.8 % (95 % CI 8-18). Increased serum levels of all the tumor markers significantly had adverse affect on survival (p = 0.001 for LDH, p = 0.002 for CEA, and p = 0.007 for CA19-9). However, no difference was observed in between high levels and very high levels of serum markers for all tumor markers (p > 0.05). Patients with normal serum levels of all three tumor markers had better outcome than others (p = 0.002) and those with normal serum LDH and CEA levels (whatever CA19-9) levels had associated with better survival compared with other possible alternatives (p < 0.001).
  
  
  CONCLUSIONS
  Serum levels of LDH, CEA, and CA19-9 had significant affect on survival in MPC patients.
authors.affiliation: Institute of Oncology, Istanbul University, Capa, 34390, Istanbul, Turkey, faruktas2002@yahoo.com.
authors.forename: Faruk
authors.initials: F
authors.lastname: Tas
authors.forename: Senem
authors.initials: S
authors.lastname: Karabulut
authors.forename: Rumeysa
authors.initials: R
authors.lastname: Ciftci
authors.forename: Fatma
authors.initials: F
authors.lastname: Sen
authors.forename: Burak
authors.initials: B
authors.lastname: Sakar
authors.forename: Rian
authors.initials: R
authors.lastname: Disci
authors.forename: Derya
authors.initials: D
authors.lastname: Duranyildiz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D018395:CA-19-9 Antigen / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D045022:Lactate Dehydrogenases / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D000093542:Gemcitabine
chemical_list: D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D003841:Deoxycytidine; D045022:Lactate Dehydrogenases; D000093542:Gemcitabine