Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT 84132, USA.
Curr Mol Med. 2013 Mar;13(3):340-51. doi: 10.2174/1566524011313030003.
CA 19-9 and CEA are the most commonly used biomarkers for diagnosis and management of patients with pancreatic cancer. Since the original compendium by Steinberg in 1990, numerous studies have reported the use of CA 19-9 and, to a lesser extent, CEA in the diagnosis of pancreatic cancer. Here we update an evaluation of the accuracy of CA 19-9 and CEA, and, unlike previous reviews, focus on discrimination between malignant and benign disease instead of normal controls. In 57 studies involving 3,285 pancreatic carcinoma cases, the combined sensitivity of CA 19-9 was 78.2% and in 37 studies involving 1,882 cases with benign pancreatic disease the specificity of CA 19-9 was 82.8%. From the combined analysis of studies reporting CEA, the sensitivity was 44.2% (1,324 cases) and the specificity was 84.8% (656 cases). These measurements more appropriately reflect the expected biomarker accuracy in the differential diagnosis of patients with periampullary diseases. We also present a summary of the use of CA 19-9 as a prognostic tool and evaluate CA 19-9 diagnostic and prognostic utility in a 10-year, single institution experience.
CA 19-9 和 CEA 是最常用于诊断和管理胰腺癌患者的生物标志物。自 1990 年 Steinberg 的原始纲要以来，许多研究报告了 CA 19-9 的使用，在较小程度上也报告了 CEA 的使用，用于诊断胰腺癌。在这里，我们更新了对 CA 19-9 和 CEA 准确性的评估，与以前的综述不同，我们专注于恶性和良性疾病之间的鉴别，而不是正常对照。在涉及 3285 例胰腺癌病例的 57 项研究中，CA 19-9 的联合敏感性为 78.2%，在涉及 1882 例良性胰腺疾病病例的 37 项研究中，CA 19-9 的特异性为 82.8%。从报告 CEA 的研究的综合分析来看，敏感性为 44.2%（1324 例），特异性为 84.8%（656 例）。这些测量更恰当地反映了在鉴别诊断胰周疾病患者时预期的生物标志物准确性。我们还总结了 CA 19-9 作为预后工具的使用情况，并评估了 CA 19-9 在 10 年单机构经验中的诊断和预后效用。
