Abstract
Pancreatic cancer has the worst prognosis of any gastrointestinal cancer, with the mortality approaching the incidence. Early detection is crucial for improving patient prognosis. We therefore performed a meta-analysis to evaluate and compare the sensitivity and specificity of CA19-9 and CA242 in pancreatic cancer. We searched PubMed, EMBASE, and the Cochrane Library for studies that evaluated the diagnostic validity of CA19-9 and CA242 between January 1966 and March 2011. Meta-analysis methods were used to pool sensitivity and specificity and to construct a summary receiver-operating characteristic (SROC) curve. A total of 11 studies that included 2,316 patients who fulfilled all of the inclusion criteria were considered for analysis. The pooled sensitivities for CA242 and CA19-9 were 0.719 (95 % confidence interval [CI] 0.690–0.746) and 0.803 (95 % CI 0.777–0.826), respectively. The pooled specificities of CA242 and CA19-9 were 0.868 (95 % CI 0.849–0.885) and 0.802 (95 % CI 0.780–0.823), respectively. The diagnostic odds ratio (DOR) estimate was significantly higher for CA242 (16.261) than for CA19-9 (15.637). Our meta-analysis showed that CA242 and CA19-9 could play different roles in the diagnosis of pancreatic cancer. Although the sensitivity of CA242 is lower than that of CA19-9, its specificity is greater.
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Maisonneuve P, Lowenfels AB (2010) Epidemiology of pancreatic cancer: an update. Dig Dis 28:645–656
Bednar F, Simeone DM (2011) Pancreatic cancer stem cell biology and its therapeutic implications. J Gastroenterol 46(12):1345–1352
Chakraborty S, Baine MJ, Sasson AR et al (2011) Current status of molecular markers for early detection of sporadic pancreatic cancer. Biochim Biophys Acta 1815:44–64
Tanase CP, Neagu M, Albulescu R et al (2010) Advances in pancreatic cancer detection. Adv Clin Chem 51:145–180
Duffy MJ, Sturgeon C, Lamerz R et al (2010) Tumor markers in pancreatic cancer: a European group on tumor markers (EGTM) status report. Ann Oncol 21:441–447
Lindholm L, Johansson C, Jaiisson EL, Hallberg C, Nilsson O (1985) An inimuno-radiometric assay (IRMA) for the CA 50 antigen. In: Holmgren J (ed) Tumour marker antigen. Studentlitteratur, Lund, pp 123–133
Zamora J, Abraira V, Muriel A et al (2006) Meta-DiSc: a software for meta-analysis of test accuracy data. BMC Med Res Methodol 6:31
Liao Q, Zhao YP, Yang YC et al (2007) Combined detection of serum tumor markers for differential diagnosis of solid lesions located at the pancreatic head. Hepatobiliary Pancreat Dis Int 6:641–645
Wu X, Lu XH, Xu T et al (2006) Evaluation of the diagnostic value of serum tumor markers, and fecal k-ras and p53 gene mutations for pancreatic cancer. Chin J Dig Dis 7:170–174
Ni XG, Bai XF, Mao YL et al (2005) The clinical value of serum CEA, CA19-9, and CA242 in the diagnosis and prognosis of pancreatic cancer. Eur J Surg Oncol 31:164–169
Jiang JT, Wu CP, Deng HF et al (2004) Serum level of TSGF, CA242 and CA19-9 in pancreatic cancer. World J Gastroenterol 10:1675–1677
Jiang XT, Tao HQ, Zou SC (2004) Detection of serum tumor markers in the diagnosis and treatment of patients with pancreatic cancer. Hepatobiliary Pancreat Dis Int 3:464–468
Ozkan H, Kaya M, Cengiz A (2003) Comparison of tumor marker CA 242 with CA 19-9 and carcinoembryonic antigen (CEA) in pancreatic cancer. Hepatogastroenterology 50:1669–1674
Banfi G, Bravi S, Ardemagni A et al (1996) CA 19.9, CA 242 and CEA in the diagnosis and follow-up of pancreatic cancer. Int J Biol Markers 11:77–81
Haglund C, Lundin J, Kuusela P et al (1994) CA 242, a new tumour marker for pancreatic cancer: a comparison with CA 19-9, CA 50 and CEA. Br J Cancer 70:487–492
Kawa S, Tokoo M, Hasebe O et al (1994) Comparative study of CA242 and CA19-9 for the diagnosis of pancreatic cancer. Br J Cancer 70:481–486
Banfi G, Zerbi A, Pastori S et al (1993) Behavior of tumor markers CA19.9, CA195, CAM43, CA242, and TPS in the diagnosis and follow-up of pancreatic cancer. Clin Chem 39:420–423
Röthlin MA, Joller H, Largiadèr F (1993) CA 242 is a new tumor marker for pancreatic cancer. Cancer 71:701–707
Winter JM, Yeo CJ, Brody JR (2013) Diagnostic, prognostic, and predictive biomarkers in pancreatic cancer. J Surg Oncol 107:15–22
Glenn J, Steinberg WM, Kurtzman SH et al (1988) Evaluation of the utility of a radioimmunoassay for serum CA19-9 levels in patients before and after treatment of carcinoma of the pancreas. J Clin Oncol 6:462–468
Pleskow DK, Berger HJ, Gyves J et al (1989) Evaluation of a serologic marker, CA19-9, in the diagnosis of pancreatic cancer. Ann Intern Med 110:704–709
Bauer TM, El-Rayes BF, Li X (2013) Carbohydrate antigen 19-9 is a prognostic and predictive biomarker in patients with advanced pancreatic cancer who receive gemcitabine-containing chemotherapy. Cancer 119:285–292
Abdel-Misih SR, Hatzaras I, Schmidt C et al (2011) Failure of normalization of CA19-9 following resection for pancreatic cancer is tantamount to metastatic disease. Ann Surg Oncol 18:1116–1121
Buxbaum JL, Eloubeidi MA (2010) Molecular and clinical markers of pancreas cancer. JOP 11:536–544
Goggins M (2005) Molecular markers of early pancreatic cancer. J Clin Oncol 23:4524–4531
Zhang LZ, Gong YF, Tu ZX (2002) Quantitative determination of serum levels of CA242 in patients with pancreatic cancer and its significance. Chin J Pancreatol 2:20–21
Gemmel C, Eickhoff A, Helmstädter L, Riemann JF (2009) Pancreatic cancer screening: state of the art. Expert Rev Gastroenterol Hepatol 3:89–96
D’Onofrio M, Gallotti A, Pozzi Mucelli R (2010) Imaging techniques in pancreatic tumors. Expert Rev Med Devices 7:257–273
Grote T, Logsdon CD (2007) Progress on molecular markers of pancreatic cancer. Curr Opin Gastroenterol 23:508–514
Mendieta Zerón H, García Flores JR, Romero Prieto M (2009) Limitations in improving detection of pancreatic adenocarcinoma. Future Oncol 5:657–668
Chakraborty S, Baine MJ, Sasson AR, Batra SK (2011) Current status of molecular markers for early detection of sporadic pancreatic cancer. Biochim Biophys Acta 1815:44–64
Bünger S, Laubert T, Roblick UJ, Habermann JK (2011) Serum biomarkers for improved diagnostic of pancreatic cancer: a current overview. J Cancer Res Clin Oncol 137:375–389
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Ji-Cong Gui and Wei-Li Yan contributed equally to this work.
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Gui, JC., Yan, WL. & Liu, XD. CA19-9 and CA242 as tumor markers for the diagnosis of pancreatic cancer: a meta-analysis. Clin Exp Med 14, 225–233 (2014). https://doi.org/10.1007/s10238-013-0234-9
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DOI: https://doi.org/10.1007/s10238-013-0234-9