title: Prognostic significance of SUVmax and serum carbohydrate antigen 19-9 in pancreatic cancer.
abstract: OBJECTIVE
  To investigate the prognostic significance of pretreatment standardized maximum uptake value (SUVmax) and serum carbohydrate antigen (CA)19-9 in pancreatic cancer.
  
  
  METHODS
  From January 2007 to October 2011, 80 consecutive patients with pancreatic cancer who received positron emission/computed tomography before any treatment were enrolled in this study. The pretreatment SUVmax and CA19-9 level of the primary pancreatic tumor were obtained and compared with clinicopathological and prognostic factors. Student's t test for unpaired data was used to analyze the differences between two groups. Univariate analysis and Cox proportional hazards regression were used to examine the independent effects of each significant variable. Survival was analyzed by the Kaplan-Meier method.
  
  
  RESULTS
  There was a significant correlation between both the SUVmax and serum CA19-9 of pancreatic cancer and R0 surgical resection (P = 0.043 and P = 0.007). Lymph node metastasis was associated with SUVmax (P = 0.017), but not serum CA19-9 (P = 0.172). On the contrary, the tumor stage was significantly related to serum CA19-9 (P = 0.035), but not SUVmax (P = 0.110). The univariate analysis showed that survival time was significantly related to tumor stage (P < 0.001), lymph node metastasis (P = 0.043), R0 surgical resection (P < 0.001), serum CA19-9 (P = 0.001), SUVmax (P < 0.001) and SUVmax plus CA19-9 (P = 0.002). Multivariate analysis clearly showed that only tumor stage (hazard ratio = 0.452; P = 0.020) was an independent prognostic factor for overall survival in pancreatic cancer. Higher SUVmax or CA19-9 showed worse prognosis. We found that high serum CA19-9 plus SUVmax was the most significant variable.
  
  
  CONCLUSIONS
  Higher pretreatment SUVmax and serum CA19-9 indicates poor prognosis. SUVmax plus serum CA19-9 is the most significant variable in predicting survival.
authors.affiliation: Jian-Guo Zhao, Ya Hu, Quan Liao, Zhe-Yu Niu, Yu-Pei Zhao, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Jian-Guo
authors.initials: JG
authors.lastname: Zhao
authors.affiliation: Jian-Guo Zhao, Ya Hu, Quan Liao, Zhe-Yu Niu, Yu-Pei Zhao, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Ya
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Jian-Guo Zhao, Ya Hu, Quan Liao, Zhe-Yu Niu, Yu-Pei Zhao, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Quan
authors.initials: Q
authors.lastname: Liao
authors.affiliation: Jian-Guo Zhao, Ya Hu, Quan Liao, Zhe-Yu Niu, Yu-Pei Zhao, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Zhe-Yu
authors.initials: ZY
authors.lastname: Niu
authors.affiliation: Jian-Guo Zhao, Ya Hu, Quan Liao, Zhe-Yu Niu, Yu-Pei Zhao, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
authors.forename: Yu-Pei
authors.initials: YP
authors.lastname: Zhao
mesh_terms: D000368:Aged; D018395:CA-19-9 Antigen / Q000097:blood*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D049268:Positron-Emission Tomography; D011379:Prognosis; D016016:Proportional Hazards Models; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D018395:CA-19-9 Antigen
keywords: Carbohydrate antigen 19-9; Maximum standardized uptake value; Pancreatic cancer; Prognostic factors