Pancreatic Cancer Insights: Optimization of the Diagnostic Capacity of Tumor Biomarkers

Lab Med. 2021 Nov 2;52(6):550-557. doi: 10.1093/labmed/lmab016.

Abstract

Objective: Pancreatic cancer (PC) is one of the deadliest malignancies. The aim of this study was to determine the usefulness of the carbohydrate antigen 19.9 (CA19.9)/ carcinoembryonic antigen (CEA) ratio as a diagnostic tool.

Methods: This was a retrospective observational study (2015-2019), including laboratory requests with increased CA19.9 and CEA but no previous neoplasia. Receiver operating characteristic (ROC) curve analyses were performed for the CA19.9/CEA ratio and for CA19.9 and CEA alone for the detection of PC, and cutoff values for all strategies were selected separately and in combination.

Results: A total of 373 individuals were included. The area under the curve (AUC) for CA19.9/CEA was 0.872, whereas the AUC for CA19.9 was 0.847 and for CEA was 0.554. Cutoff values with the greatest diagnostic power were CA19.9/CEA >40, CA19.9 >1130 U/mL, and CEA > 14.5 U/mL. The combination of CA19.9/CEA > 40 with CA19.9 > 550 U/mL maximized the diagnostic accuracy for PC.

Conclusion: Our results highlight the relevance of the measurement of serum CA19.9 and CEA in the detection of PC.

Keywords: clinical chemistry; clinical pathology; gastrointestinal; management/administration; pancreas; tumor marker.

Publication types

  • Observational Study

MeSH terms

  • Biomarkers, Tumor
  • CA-19-9 Antigen
  • Humans
  • Pancreatic Neoplasms* / diagnosis
  • ROC Curve
  • Retrospective Studies

Substances

  • Biomarkers, Tumor
  • CA-19-9 Antigen