title: CA19-9-Low&Lewis (+) pancreatic cancer: A unique subtype.
abstract: The study was performed to identify unique subtype from the long-term survival (>24 months) patients with advanced pancreatic cancer (1039 cases). Long-term survival patients had higher proportion of low secretion of carbohydrate antigen 19-9 (CA19-9) than that of patients with non long-term survival (P < 0.001). Considering the impact of Lewis status on CA19-9 secretion, Lewis genotypes were further determined by Sanger sequencing. The prognosis of CA19-9-Low&Lewis (-) patients was worse than that of CA19-9-Low&Lewis (+) (hazard ratio (HR) = 0.37, P < 0.001). The proportion of epidermal growth factor receptor (EGFR) (-) cases was lower in the CA19-9-Low&Lewis (+) subgroup than that in other patients (P = 0.047). For the CA19-9-Low&Lewis (+) subgroup, chemotherapy plus radiotherapy but not chemotherapy was found to be an independent prognostic factor (versus best supportive care, chemotherapy, HR = 0.71, P = 0.267; chemotherapy plus radiotherapy, HR = 0.33, P = 0.022). We conclude that CA19-9-Low&Lewis (+) pancreatic cancer is a unique subtype with special biological properties.
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
authors.forename: Guopei
authors.initials: G
authors.lastname: Luo
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Guo
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Long
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
authors.forename: Zuqiang
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
authors.forename: Zhiwen
authors.initials: Z
authors.lastname: Xiao
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
authors.forename: Kaizhou
authors.initials: K
authors.lastname: Jin
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
authors.forename: He
authors.initials: H
authors.lastname: Cheng
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
authors.forename: Quanxing
authors.initials: Q
authors.lastname: Ni
authors.affiliation: Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China. Electronic address: yuxianjun@fudanpci.org.
authors.forename: Xianjun
authors.initials: X
authors.lastname: Yu
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000276:immunology* / Q000401:mortality / Q000628:therapy; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018395:CA-19-9 Antigen / Q000097:blood*; D059248:Chemoradiotherapy; D016009:Chi-Square Distribution; D016208:Databases, Factual; D005260:Female; D005647:Fucosyltransferases / Q000235:genetics*; D020022:Genetic Predisposition to Disease; D006801:Humans; D053208:Kaplan-Meier Estimate; D016256:Lewis X Antigen / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000235:genetics* / Q000276:immunology* / Q000401:mortality / Q000628:therapy; D010641:Phenotype; D016016:Proportional Hazards Models; D012307:Risk Factors; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D018395:CA-19-9 Antigen; D016256:Lewis X Antigen; C066693:FUT4 protein, human; D005647:Fucosyltransferases
keywords: CA19-9; Heterogeneity; Lewis antigen; Pancreatic adenocarcinoma