Yonsei Med J.  2013 May;54(3):643-649. 10.3349/ymj.2013.54.3.643.

Serum CA 19-9 and CEA Levels as a Prognostic Factor in Pancreatic Adenocarcinoma

• Lee KJ
• Yi SW
• Chung MJ
• Park SW
• Song SY
• Chung JB
• Park JY

• KMID: 1727877
• DOI: http://doi.org/10.3349/ymj.2013.54.3.643

Abstract

PURPOSE
To investigate the use of pretreatment carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) as prognostic factors to determine survival in pancreatic adenocarcinoma.
MATERIALS AND METHODS
A retrospective review of the medical records of patients who were diagnosed with pancreatic adenocarcinoma and received surgery, chemoradiotherapy or chemotherapy was performed. Factors, including CA 19-9 and CEA, associated with the survival of pancreatic cancer patients were analyzed.
RESULTS
Patients with the median age of 65 years were included (n=187). Elevated serum CA 19-9 levels and CEA levels were observed in 75.4% and 39% of patients at diagnosis, respectively. CEA was correlated with tumor stages (p=0.005), but CA 19-9 was not. CA 19-9 and CEA were elevated in 69.0% and 33.3% of patients with resectable pancreatic cancer, and elevated in 72.9% and 47.2% of patients with advanced pancreatic cancer, respectively. The median overall survival of the normal serum CEA group was longer than that of the elevated serum CEA group (16.3 months vs. 10.2 months, p=0.004). However, the median overall survival of the normal serum CA 19-9 group was not different from that of the elevated serum CA 19-9 group (12.4 months vs. 13.5 months, p=0.969). The independent factors associated with overall survival were advanced pancreatic cancer [harzard ratio (HR) 4.33, p=0.001] and elevated serum CEA level (HR 1.52, p=0.032).
CONCLUSION
Patients with elevated serum CEA level at diagnosis demonstrated poor overall survival. Pretreatment CEA level may predict the prognosis of patients with pancreatic adenocarcinoma.

Keyword

CA 19-9; carcinoembryonic antigen; pancreas adenocarcinoma; prognosis

MeSH Terms

Adenocarcinoma/blood/*diagnosis
Adult
Aged
Aged, 80 and over
Antigens, Tumor-Associated, Carbohydrate/*blood
Carcinoembryonic Antigen/*blood
Female
Humans
Male
Middle Aged
Pancreatic Neoplasms/blood/*diagnosis
Prognosis
Retrospective Studies
Survival Analysis
Antigens, Tumor-Associated, Carbohydrate
Carcinoembryonic Antigen

Figure

• 

  Fig. 1 Overall survival. (A) Comparison of survival time between the normal CA 19-9 group and the elevated CA 19-9 group. (B) Comparison of survival time between the normal CEA group and the elevated CEA group. CA 19-9, carbohydrate antigen 19-9; CEA, carcinoembryonic antigen.

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