Taylor & Francis Group
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Elevated CEA and CA19-9 serum levels independently predict advanced pancreatic cancer at diagnosis

posted on 2020-02-14, 06:41 authored by Labrinus van Manen, Jesse V. Groen, Hein Putter, Alexander L. Vahrmeijer, Rutger-Jan Swijnenburg, Bert A. Bonsing, J. Sven D. Mieog

Purpose: It is suggested that tumour markers carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) could be used to predict the stage of pancreatic cancer. However, optimal cut-off values for CEA and CA19-9 are disputable. This study aimed to assess the value of CEA and CA19-9 serum levels at diagnosis of pancreatic ductal adenocarcinoma (PDAC) as predictors for the advanced stage of PDAC in patients discussed at pancreatic multidisciplinary team (MDT) meetings.

Methods: Patients with suspected PDAC discussed at MDT meetings from 2013 to 2017 were reviewed, in order to determine optimal cut-off values of both CEA and CA19-9.

Results: In total, 375 patients were included. Optimal cut-off values for predicting advanced PDAC were 7.0 ng/ml for CEA and 305.0 U/ml for CA19-9, resulting in positive predictive values of 83.3%, 73.6%, and 91.4% for CEA, CA19-9 and combined, respectively. Both tumour markers were independent predictors of advanced PDAC, demonstrated by an odds ratio of 4.21 (95% CI:1.85–9.56; p = 0.001) for CEA and 2.58 for CA19-9 (95% CI:1.30–5.14; p = 0.007).

Conclusions: CEA appears to be a more robust predictor of advanced PDAC than CA19-9. Implementing CEA and CA19-9 serum levels during MDT meetings as an additional tool for establishing tumour resectability is worthwhile for tailored diagnostics.


This work was supported by the Bas Mulder Award [grant UL2015-7665] from the Alpe d’HuZes foundation/Dutch Cancer Society.