Elevated CA19-9 Is Associated With Increased Mortality In A Prospective Cohort Of Hepatocellular Carcinoma Patients

Hsu, Christine; Goyal, Abhishek; Iuga, Alina; Krishnamoorthy, Saravanan; Lee, Valerie; Verna, Elizabeth C.; Wang, Shuang; Chen, Fei Na; Rodríguez, Rosa; Emond, Jean C.; Berk, Paul D.; Lefkowitch, Jay H.; Dove, Lorna; Brown, Robert S.; Siegel, Abby B.

doi:10.1038/ctg.2014.22

Cited by 20 publications

(19 citation statements)

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“…However, the study only included patients with liver transplantation and did not exclude patients with ICC or cHCC-CC. Hsu et al [8] investigated 145 cases of HCV-related HCC and found that an elevated serum CA19-9 level of ≥ 100 U/ml is an independent predictor of poor OS. However, 59% (85/145) of the HCC patients had underlying hepatitis C virus, and only 16% had hepatitis B virus.…”

Section: Discussionmentioning

confidence: 99%

“…It is also frequently elevated in patients with combined HCC-cholangiocarcinoma. Elevated preoperative serum CA19-9 levels have been reported to be associated with worse survival in HCC patients who had undergone resection (> 27 U/mL) or liver transplantation (> 100 U/ml) [8][9][10]. However, most of these studies mainly included patients with HCVrelated HCC who underwent resection or transplantation, and the underlying mechanism by which CA19-9 in uences prognosis remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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Serum CA19-9 Level is Correlated with Liver Inflammation, Cirrhosis, and Poor Prognosis after Curative Resection in Hepatitis B-related Hepatocellular Carcinoma

Zhang¹,

Wang²,

Yang³

et al. 2020

Preprint

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Background: The relationship between serum carbohydrate antigen 19-9 (CA19-9) and hepatocellular carcinoma (HCC) is unclear. To explore the prognostic value of preoperative CA19-9 in α-fetoprotein (AFP)-positive and -negative HCC with hepatitis B virus (HBV) background (HBV-HCC).Methods: We evaluated HBV-HCC patients who underwent curative resection (Cohort 1). Recurrence-free survival (RFS) and overall survival (OS) were assessed, and the clinicopathological characteristics were compared according to a CA19-9 cutoff of ≥ 39 U/ml. Immunohistochemical staining of CA19-9 in HCC tumor tissue and background liver were quantified in another cohort of 216 patients with resected HCC (Cohort 2). Immunohistochemical staining or serum CA19-9 level was also compared between patients with intrahepatic cholangiocarcinoma (ICC) (Cohort 3).Results: In Cohort 1, CA19-9 ≥ 39 U/ml was an independent risk factor for RFS (HR=1.507, 95% CI=1.087-2.091, p=0.014) and OS (HR=1.646, 95% CI=1.146-2.366, p=0.007) in both AFP-positive and AFP-negative patients. CA19-9 ≥ 39 U/ml was also associated with significantly higher incidence of macrovascular invasion compared with CA19-9 < 39 U/ml (23.0% vs. 7.2%, p=0.002), elevated aminotransferase and aspartate aminotransferase to platelet ratio index, and lower albumin. In contrast, no association was found between CA19-9 and systemic inflammation. CA19-9 expression was found exclusively in the background liver but not in HCC tumor cells. In contrast, tumor tissue was the main source of CA19-9 in ICC patients.Conclusions: CA19-9 ≥ 39 U/ml was associated with lower OS and RFS in both AFP-positive and negative HCC patients. CA19-9 is secreted by the background liver but not by tumor cells. Thus, CA19-9 is a prognostic marker for liver inflammation and cirrhosis in HCC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Serum CA19-9 Level is Correlated with Liver Inflammation, Cirrhosis, and Poor Prognosis after Curative Resection in Hepatitis B-related Hepatocellular Carcinoma

Zhang¹,

Wang²,

Yang³

et al. 2020

Preprint

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“…Although CA 19-9 expression is also related to unfavorable prognosis in some kinds of cancer, why high CA 19-9 predict shorter OS is not understood [34, 35]. We therefore investigated the relationship between CA 19-9 IHC positivity and pathological findings in patients with stage I lung adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

The prognostic value of serum CA 19-9 for patients with advanced lung adenocarcinoma

et al. 2016

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BackgroundThis study aimed to assess the prognostic accuracy of serum CA 19-9 in patients with advanced lung adenocarcinoma.MethodsWe retrospectively reviewed data of 246 patients who were diagnosed at our institute with advanced (stage IIIB or IV) lung adenocarcinoma between March 2006 and December 2012. We excluded patients who received no chemotherapy, or for whom we had no data on pre-treatment tumor markers. We also evaluated 116 consecutive resected specimens from patients with clinical stage I lung adenocarcinoma pathologically.ResultsThe 76 (31 %) patients who were CA 19-9+ had shorter overall survival (OS) than CA 19-9− group (12.5 vs 26.2 months, P = 0.005). Cox’s multivariate regression analysis identified Eastern Cooperative Oncology Group Performance Status 0 or 1 (P < 0.001), mutated epidermal growth factor receptor (EGFR) status (P < 0.001), stage IIIB (P < 0.001), CYFRA 21-1− (P < 0.001), CA 19-9− (P = 0.005) and use of platinum doublet therapy (P = 0.034) as independent predictors of longer OS. We stratified patients by CA 19-9 and CYFRA 21-1 as double positive (CA 19-9+/CYFRA 21-1+, n = 59), single positive (either CA19-9+ or CYFRA 21-1+, n = 113), or double negative (CA 19-9−/CYFRA 21-1−, n = 74). Their respective OS were 10.0, 23.3 and 31.8 months (P < 0.001). Pathological analysis also correlated CA 19-9 expression with malignant features such as vessel invasion, pleural invasion, cancer invasive factors and mucin production.ConclusionsCA 19-9 and CYFRA 21-1 are independent prognostic markers in patients with advanced lung adenocarcinoma. Combined use of CA 19-9 and CYFRA 21-1 provides further prognostic information in patients with advanced lung adenocarcinoma.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2897-6) contains supplementary material, which is available to authorized users.

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“…CA19-9 is used primarily in combination with other biomarkers (e.g., CEA) for the monitoring and management of pancreatic cancer [ 90 ]. CA19-9 is also currently recognised as one of the most common tumour markers for colorectal, gastric, and hepatocellular cancer [ 97 ]. The latter three types of cancer contribute to 28% and 16% of cancer-associated deaths in males and females, respectively ( Figure 1 ).…”

Section: Clinically Approved Biomarkersmentioning

confidence: 99%

Glycosylation-Based Serum Biomarkers for Cancer Diagnostics and Prognostics

Kirwan

Utratna

O’Dwyer

et al. 2015

BioMed Research International

181

143

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Cancer is the second most common cause of death in developed countries with approximately 14 million newly diagnosed individuals and over 6 million cancer-related deaths in 2012. Many cancers are discovered at a more advanced stage but better survival rates are correlated with earlier detection. Current clinically approved cancer biomarkers are most effective when applied to patients with widespread cancer. Single biomarkers with satisfactory sensitivity and specificity have not been identified for the most common cancers and some biomarkers are ineffective for the detection of early stage cancers. Thus, novel biomarkers with better diagnostic and prognostic performance are required. Aberrant protein glycosylation is well known hallmark of cancer and represents a promising source of potential biomarkers. Glycoproteins enter circulation from tissues or blood cells through active secretion or leakage and patient serum is an attractive option as a source for biomarkers from a clinical and diagnostic perspective. A plethora of technical approaches have been developed to address the challenges of glycosylation structure detection and determination. This review summarises currently utilised glycoprotein biomarkers and novel glycosylation-based biomarkers from the serum glycoproteome under investigation as cancer diagnostics and for monitoring and prognostics and includes details of recent high throughput and other emerging glycoanalytical techniques.

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Elevated CA19-9 Is Associated With Increased Mortality In A Prospective Cohort Of Hepatocellular Carcinoma Patients

Cited by 20 publications

References 40 publications

Serum CA19-9 Level is Correlated with Liver Inflammation, Cirrhosis, and Poor Prognosis after Curative Resection in Hepatitis B-related Hepatocellular Carcinoma

Serum CA19-9 Level is Correlated with Liver Inflammation, Cirrhosis, and Poor Prognosis after Curative Resection in Hepatitis B-related Hepatocellular Carcinoma

The prognostic value of serum CA 19-9 for patients with advanced lung adenocarcinoma

Glycosylation-Based Serum Biomarkers for Cancer Diagnostics and Prognostics

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