J Korean Med Sci.  2015 Mar;30(3):259-263. 10.3346/jkms.2015.30.3.259.

Postoperative Carcinoembryonic Antigen as a Complementary Tumor Marker of Carbohydrate Antigen 19-9 in Pancreatic Ductal Adenocarcinoma

• Kim J
• Lee YS
• Hwang IK
• Kang BK
• Cho JY
• Yoon YS
• Han HS
• Hwang JH

• KMID: 2133302
• DOI: http://doi.org/10.3346/jkms.2015.30.3.259

Abstract

The role of carcinoembryonic antigen (CEA) in pancreatic cancer remains poorly understood. Therefore, this study aimed to determine whether CEA is complementary to carbohydrate antigen 19-9 (CA19-9) in prognosis prediction after pancreatic cancer curative resection. We retrospectively reviewed records of 144 stage II curatively resected pancreatic cancer patients with preoperative and postoperative CEA and CA19-9 levels. Patients with normal preoperative CA19-9 were excluded. R0 resection margin, adjuvant treatment, and absence of angiolymphatic invasion were associated with better overall survival. There was no significant difference in median survival according to preoperative CEA levels. However, patients with normal postoperative CA19-9 (59.8 vs.16.2 months, P < 0.001) and CEA (29.4 vs. 9.3 months, P = 0.001) levels had longer overall survival than those with elevated levels. Among 76 patients with high postoperative CA19-9 levels, a better prognosis was observed in those with normal postoperative CEA levels than in those with elevated levels (19.1 vs. 9.3 months, P = 0.004). Postoperative CEA and CA19-9 levels are valuable prognostic markers in resected pancreatic cancer. Normal postoperative CEA levels indicate longer survival, even in patients with elevated postoperative CA19-9.

Keyword

Pancreatic Neoplasms; Carcinoembryonic Antigen; CA 19-9; Prognosis; Survival

MeSH Terms

Adjuvants, Immunologic/therapeutic use
Adult
Aged
Aged, 80 and over
Biomarkers, Tumor/*blood
CA-19-9 Antigen/*blood
Carcinoembryonic Antigen/*blood
Carcinoma, Pancreatic Ductal/*blood/mortality/therapy
Female
Humans
Male
Middle Aged
Pancreatic Neoplasms/*blood/mortality/therapy
Postoperative Period
Prognosis
Retrospective Studies
Adjuvants, Immunologic
Biomarkers, Tumor
CA-19-9 Antigen
Carcinoembryonic Antigen

Figure

• 

  Fig. 1 Kaplan-Meier analysis of overall survival according to postoperative carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) levels. (A) The postoperative CA19-9 level is significantly associated with overall survival in patients with curatively resected stage II pancreatic cancer. The median overall survival time was 59.8 months in patients with normal CA19-9 levels and 16.2 months in those with high CA19-9 levels. (B) The postoperative CEA level is also significantly associated with overall survival in patients with curatively resected stage II pancreatic cancer. The median overall survival time in patients with normal and high CEA levels was 29.4 and 9.3 months, respectively.

• 

  Fig. 2 Kaplan-Meier analysis of overall survival according to postoperative levels of both carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9). The median survival of patients with normal postoperative CEA and CA19-9 levels was excellent at 59.8 months. Among the 76 patients with high postoperative CA19-9 levels, those with normal postoperative CEA levels had better overall survival than those with high CEA levels (19.1 [normal CEA/high CA19-9] vs. 9.3 months [high CEA/highCA19-9]) (*P < 0.001; †P = 0.004).

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