Tumor markers in pancreatic cancer: a European Group on Tumor Markers (EGTM) status report

Serum CA 19-9 as a Biomarker for Pancreatic Cancer—A Comprehensive Review

“…Despite multiple clinical applications for CA 19-9 serum levels in pancreatic cancer patients, the diagnostic utility of CA 19-9 is often limited due to a low or modest sensitivity (79-81%) in symptomatic patients [12,14,15]. Moreover, a very low PPV (0.9%) makes CA 19-9 serum levels a suboptimal test to screen asymptomatic populations [16][17][18].…”

“…Le (α-β-) phenotypes occur in 5-10% of population which lack the enzyme 1,4-fucosyl transferase required for antigen epitope production, and as such limits the use of CA 19-9 as a universally applicable biomarker [12][13][14][15].…”

Pancreato-Biliary Cancers – Diagnosis and Management

“…Carbohydrate antigen 19-9 (CA19-9), which is caused by the up-regulation of glycosyl transferase genes, is the most commonly used marker and can provide useful diagnostic and prognostic information (Duffy et al 2010). Its sensitivity (70%-90%) and specificity (43%-91%) for diagnosing pancreatic cancer are only modest and can be falsely increased by high serum bilirubin (Duffy et al 2010). However, for those with confirmed pancreatic cancer, high serum CA19-9 is associated with a worse survival (Park et al, 2008).…”

Diagnostic utility of clinical and biochemical parameters in pancreatic head malignancy patients with normal carbohydrate antigen 19-9 levels

“…In addition, CA19-9 could not be detected in subjects with Lewis a-b-genotype 9 . Furthermore, only about 50% of patients with pancreatic carcinomas of <3cm had elevated CA19-9 levels, and poorly differentiated malignant tumors secreted lower concentrations of CA19-9 than medium/well-differentiated ones did 10 . Given these limitations, malignant carriers with normal CA19-9 levels but positive imaging findings would appear even more difficult in distinguishing from benign ones.…”