title: CA-125, but not galectin-3, complements CA 19-9 for discriminating ductal adenocarcinoma versus non-malignant pancreatic diseases.
abstract: OBJECTIVE
  CA 19-9 is the gold standard biomarker of pancreatic adenocarcinoma despite several weaknesses in particular a high rate of false positives or negatives. CA-125 corresponding to MUC16 and galectin-3, a lectin able to interact with mucin-associated carbohydrates, are tumor-associated proteins. We investigated whether combined measurement of CA 19-9, galectin-3 and CA-125 may help to better discriminate pancreatic adenocarcinoma versus non-malignant pancreatic diseases.
  
  
  METHODS
  We evaluated by immunohistochemistry the expression of MUC4, MUC16 (CA-125) and galectin-3 in 31 pancreatic adenocarcinomas. We measured CA 19-9, CA-125 and Gal-3 in the serum from patients with pancreatic benign diseases (n = 58) or adenocarcinoma (n = 44). Clinical performance of the 3 biomarkers for cancer diagnosis and prognosis was analyzed.
  
  
  RESULTS
  By immunohistochemistry, MUC16 and Gal-3 were expressed in 74% and 84% of adenocarcinomas versus 0% and 3.2% in peri-tumoral regions, respectively. At the serum level, CA 19-9 and CA125 were significantly higher in patients with pancreatic adenocarcinoma whereas Gal-3 levels did not differ. The performance of CA 19-9 for cancer detection was higher than those of CA-125 or Gal-3 by ROC analysis. However, CA-125 offers the highest specificity for malignancy (81%) because of an absence of false positives among type 2 diabetic patients. Cancer deaths assessed 6 or 12 months after diagnosis varied according to the initial CA-125 level (p < 0.006).
  
  
  CONCLUSIONS
  Gal-3 is not an interesting biomarker for pancreatic adenocarcinoma detection. CA 19-9 alone exhibits the best performance but measuring CA-125 provides complementary information in terms of diagnosis and prognosis.
authors.affiliation: Institut de Biochimie et Biologie Moléculaire, CHRU, Lille, France; INSERM UMR-S1172/Jean-Pierre Aubert Research Center (JPARC), Lille, France.
authors.forename: Lucie
authors.initials: L
authors.lastname: Coppin
authors.affiliation: INSERM UMR-S1172/Jean-Pierre Aubert Research Center (JPARC), Lille, France; Service d'Endocrinologie et métabolismes, CHRU, Lille, France.
authors.forename: Kanza
authors.initials: K
authors.lastname: Benomar
authors.affiliation: Service de Chirurgie Digestive et Transplantation, CHRU, Lille, France.
authors.forename: François
authors.initials: F
authors.lastname: Corfiotti
authors.affiliation: Service d'Hépato-Gastroentérologie, CHRU, Lille, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Cattan
authors.affiliation: Institut de Pathologie, Centre de Biologie Pathologie, CHRU, Lille, France; INSERM UMR-S1172/Jean-Pierre Aubert Research Center (JPARC), Lille, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Renaud
authors.affiliation: Institut de Pathologie, Centre de Biologie Pathologie, CHRU, Lille, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Lapere
authors.affiliation: Institut de Pathologie, Centre de Biologie Pathologie, CHRU, Lille, France; INSERM UMR-S1172/Jean-Pierre Aubert Research Center (JPARC), Lille, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Leteurtre
authors.affiliation: Service d'Endocrinologie et métabolismes, CHRU, Lille, France; INSERM U1190, Lille, France.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Vantyghem
authors.affiliation: Service de Chirurgie Digestive et Transplantation, CHRU, Lille, France; INSERM UMR-S1172/Jean-Pierre Aubert Research Center (JPARC), Lille, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Truant
authors.affiliation: Institut de Biochimie et Biologie Moléculaire, CHRU, Lille, France; INSERM UMR-S1172/Jean-Pierre Aubert Research Center (JPARC), Lille, France. Electronic address: pascal.pigny@chru-lille.fr.
authors.forename: Pascal
authors.initials: P
authors.lastname: Pigny
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001798:Blood Proteins; D018394:CA-125 Antigen / Q000097:blood / Q000235:genetics / Q000378:metabolism*; D018395:CA-19-9 Antigen / Q000097:blood / Q000235:genetics / Q000378:metabolism*; D005260:Female; D037502:Galectin 3 / Q000097:blood / Q000235:genetics / Q000378:metabolism*; D037161:Galectins; D015972:Gene Expression Regulation, Neoplastic / Q000502:physiology*; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000235:genetics / Q000378:metabolism; D008875:Middle Aged; D055264:Mucin-4 / Q000235:genetics / Q000378:metabolism; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism*; D016019:Survival Analysis
chemical_list: D001798:Blood Proteins; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; D037502:Galectin 3; D037161:Galectins; C428445:LGALS3 protein, human; C451759:MUC16 protein, human; C524658:MUC4 protein, human; D008565:Membrane Proteins; D055264:Mucin-4
keywords: Diabetes; Galectin-3; MUC16; Pancreatic adenocarcinoma; Pancreatitis; Tumor markers