Chang Chi-Yang, Huang Shih-Pei, Chiu Han-Mo, Lee Yi-Chia, Chen Min-Fong, Lin Jaw-Town
Department of Internal Medicine, National Taiwan University Hospital, Taipei.
Hepatogastroenterology. 2006 Jan-Feb;53(67):1-4.
BACKGROUND/AIMS: Serum levels of carbohydrate antigen (CA) 19-9 have long been employed as a biomarker in diagnosing pancreatic cancer in symptomatic patients. We assessed the clinical usefulness of serum CA 19-9 in screening pancreatic cancer and other malignancies in individuals without symptoms.
The study enrolled 5,343 consecutive asymptomatic individuals who completed a health check-up comprising serum CA 19-9, chest film, abdominal ultrasonography, esophagogastroduodenoscopy, and colonoscopy or sigmoidoscopy. The sensitivity, specificity and positive predictive rate of CA 19-9 in detecting cancers were analyzed.
There were 385 patients (7.2%) with CA 19-9 higher than 37 U/mL. Two patients diagnosed with pancreatic cancer had CA 19-9 levels of 46,885 U/mL and 88.4 U/mL, respectively. Thirteen among 58 patients with other cancers had CA 19-9 levels higher than 37 U/mL. If the cut-off value of CA 19-9 was set at 37 U/mL, the sensitivity and specificity for pancreatic cancer and other cancers were 100% and 92.8%, as well as 22.4% and 92.9%, respectively. However, the positive predictive rates for pancreatic cancer and other cancers were as low as 0.5% and 3.4%, respectively.
Efficacy of CA 19-9 in predicting either pancreatic cancer or other cancers in the asymptomatic population is low.
背景/目的：长期以来，血清糖类抗原（CA）19-9水平一直被用作有症状患者胰腺癌诊断的生物标志物。我们评估了血清CA 19-9在无症状个体中筛查胰腺癌和其他恶性肿瘤的临床实用性。
该研究纳入了5343名连续的无症状个体，他们完成了包括血清CA 19-9、胸部X光、腹部超声、食管胃十二指肠镜检查以及结肠镜检查或乙状结肠镜检查在内的健康体检。分析了CA 19-9检测癌症的敏感性、特异性和阳性预测率。
385名患者（7.2%）的CA 19-9高于37 U/mL。两名被诊断为胰腺癌的患者CA 19-9水平分别为46,885 U/mL和88.4 U/mL。58名患有其他癌症的患者中有13名CA 19-9水平高于37 U/mL。如果将CA 19-9的临界值设定为37 U/mL，那么其对胰腺癌和其他癌症的敏感性和特异性分别为100%和92.8%，以及22.4%和92.9%。然而，胰腺癌和其他癌症的阳性预测率分别低至0.5%和3.4%。
CA 19-9在预测无症状人群中的胰腺癌或其他癌症方面效果不佳。
