title: Diagnostic value of combining CA 19-9 and K-ras gene mutation in pancreatic carcinoma: a meta-analysis.
abstract: OBJECTIVE
  To assess diagnostic value of Carbohydrate Antigen 19-9 (CA 19-9), combined CA 19-9 and K-ras mutation in plasma DNA in diagnosing patients with pancreatic carcinoma.
  
  
  METHODS
  MEDLINE, EMBASE, the Cochrane Library, Sinomed, CNKI and other databases, from established to November, 2013, were searched for initial studies. All the studies published in English or Chinese relating to the diagnostic value of CA 19-9 and K-ras gene mutation for patients with pancreatic cancer were collected. Methodological quality was assessed. The statistic software called "Meta-disc" (version 1.4) was used for data analysis.
  
  
  RESULTS
  10 studies were included in this meta-analysis. The pooled sensitivity estimate for CA 19-9 (78%) was significantly higher than K-ras mutation (65%). While, for the specificity estimate, K-ras mutation (93%) was significantly higher than CA 19-9 (77%). The pooled DOR estimate for K-ras mutation (21.82) was significantly higher than CA 19-9 (18.36). SROC curves for K-ras mutation showed better diagnostic accuracy than CA 19-9. For CA 19-9 measurement, its diagnostic value decreased in differentiating pancreatic cancer for patients with pancreatitis, especially chronic process.
  
  
  CONCLUSIONS
  CA 19-9 was a high sensitive and K-ras was a high specific method in diagnosing patients with pancreatic cancer. These two modalities probably act different roles during different conditions in diagnosing pancreatic carcinoma.
authors.affiliation: Department of General Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai, People's Republic of China.
authors.forename: Jiangning
authors.initials: J
authors.lastname: Gu
authors.affiliation: Department of Prophylactic Medicine, Shanghai First People's Hospital, Shanghai Jiao Tong University Shanghai, People's Republic of China.
authors.forename: Di
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Endocrine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai, People's Republic of China.
authors.forename: Ya
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai, People's Republic of China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of General Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai, People's Republic of China.
authors.forename: Chenghong
authors.initials: C
authors.lastname: Peng
keywords: Carbohydrate antigen 19-9; K-ras mutation; diagnosis; meta-analysis; pancreatic carcinoma