TPS, CA 19-9, VEGF-A, and CEA as Diagnostic and Prognostic Factors in Patients with Mass Lesions in the Pancreatic Head

Abstract

Introduction: Although numerous tumour markers are available for periampullary tumours, including pancreatic cancer, their specificity and sensitivity have been questioned. Materials and methods:To assess the diagnostic and prognostic values of tissue polypeptide specific antigen (TPS), carbohydrate antigen 19-9 (CA 19-9), vascular endothelial growth factor (VEGF-A), and carcinoembryonic antigen (CEA) we took serum samples in 56 patients with mass lesions in the pancreatic head. Among these patients, further investigations revealed pancreatic cancer in 20 patients, other malignant diseases in 12 and benign conditions in 24.Results: Median CEA in all patients was 3.4 μg/L (range 0.5-585.0), median CA 19-9 was105 kU/L (range 0.6-1 300 00), median TPS 123.5 U/L (range 15.0-3350) and median VEGF-A 132.5 ng/L (range 60.0-4317). Area under the curve was 0.747, standard error (standard error [SE] =0.075) for CEA, 0.716 (SE=0.078) for CA 19-9 and 0.822 (SE=0.086) for TPS in ROC plots based on the ability of the tumours to distinguish between benign and malignant conditions. None of the markers significantly predicted survival in the subgroup of patients with pancreatic cancer. Discussion: Our study shows that the markers may be used as fairly reliable diagnostic tools, but cannot be used to predict survival.

Combining conventional and stroma-derived tumour markers in pancreatic ductal adenocarcinoma

“…Furthermore, in our patient cohort, in the postoperative setting, only stromal markers were associated with overall survival, with high levels of type IV collagen, endostatin/type XVIII collagen and OPN indicating poor prognosis. In the same patients, no such associations could be observed for TPS, Ca 19-9 or Ca 125, and this is well in line with the findings by Sandblom et al [30]. However, in other studies with much larger patient materials, high levels of Ca 19-9 preoperatively [31,32] and postoperatively [33] have been shown to be associated with poor prognosis.…”

Updates and Critical Evaluation on Novel Biomarkers for the Malignant Progression of Intraductal Papillary Mucinous Neoplasms of the Pancreas

“…It is commonplace among literature that the carcinoembryonic antigen (CEA) is the most commonly used biomarker for the diagnosis and follow-up of IPMN (18). CEA is a glycoprotein of the cell surface whose levels are elevated in over 60% of patients with pancreatic ductal adenocarcinoma.…”

“…The carbohydrate antigen 19-9 (CA19-9) is the other biomarker often used for the diagnosis of IPMNs (18,26). It is a tumor-associated glycoprotein.…”

Type IV collagen is a tumour stroma-derived biomarker for pancreas cancer

“…Several different substances have been identified as potential biomarkers in pancreas cancer, such as LMO4 (Murphy et al, 2008), c-kit (Kimura et al, 2007), TPS, CA 19-9, VEGF-A and CEA (Slesak et al, 2004;Sandblom et al, 2008) in serum, and telomerase activity in pancreatic juice (Uehara et al, 2008). However, few of these are used in clinical praxis, and the specificity and sensitivity for many have been questioned.…”