Department of Internal Medicine, Korea University College of Medicine, Seoul 08308, Korea.
Department of Internal Medicine, Korea University College of Medicine, Seoul 08308, Korea.
Hepatobiliary Pancreat Dis Int. 2018 Jun;17(3):263-268. doi: 10.1016/j.hbpd.2018.04.001. Epub 2018 Apr 20.
Generally, carbohydrate antigen 19-9 (CA 19-9) is not useful for screening pancreatic cancer in the asymptomatic general population. This study aimed to evaluate the utility of CA 19-9 level as a screening indicator of pancreatic cancer in asymptomatic patients with new-onset diabetes.
We retrospectively reviewed the medical records of patients who visited our health promotion center for health check-ups without cancer related symptoms from January 2005 to January 2014, and were newly diagnosed with diabetes mellitus (DM) within 2 years before their visit.
Of the 5111 asymptomatic patients with new-onset DM (<2 years) selected for analyses, 87 (1.7%) eventually developed pancreatic cancer after the health check-up. In the subgroup of 322 patients with high total bilirubin levels (>1.7 mg/dL) at the screening time, 42 (73.7%) of 57 patients with high CA 19-9 levels (>37 IU/mL) had been diagnosed as pancreatic cancer during follow-up period and 12 (4.5%) of 265 patients with normal CA 19-9 levels had finally developed pancreatic cancer (OR = 16.3). In the subgroup of 4789 patients with normal bilirubin levels, pancreatic cancer had been detected in 20 (3.8%) of 522 patients with high CA 19-9 level, while only 13 (0.3%) in 4267 patients with normal CA 19-9 levels (OR = 12.6), respectively.
CA 19-9 levels after a diagnosis of new-onset DM could be a useful biomarker of pancreatic cancer, especially in patients with high serum bilirubin.
一般来说，在无症状的普通人群中，糖链抗原 19-9（CA 19-9）对筛查胰腺癌并无帮助。本研究旨在评估 CA 19-9 水平作为无症状新发糖尿病患者胰腺癌筛查指标的效用。
我们回顾性分析了 2005 年 1 月至 2014 年 1 月期间因无癌症相关症状而到我们健康促进中心进行健康检查且在就诊前 2 年内新诊断为糖尿病（DM）的患者的病历。
在 5111 名新诊断为 DM（<2 年）的无症状患者中，87 例（1.7%）在健康检查后最终被诊断为胰腺癌。在筛选时总胆红素水平较高（>1.7mg/dL）的 322 例患者亚组中，57 例 CA 19-9 水平较高（>37IU/mL）的患者中有 42 例（73.7%）在随访期间被诊断为胰腺癌，而 265 例 CA 19-9 水平正常的患者中有 12 例（4.5%）最终被诊断为胰腺癌（OR=16.3）。在总胆红素水平正常的 4789 例患者亚组中，CA 19-9 水平较高的 522 例患者中有 20 例（3.8%）检出胰腺癌，而 CA 19-9 水平正常的 4267 例患者中仅 13 例（0.3%）检出胰腺癌（OR=12.6）。
新发 DM 诊断后 CA 19-9 水平可能是胰腺癌的有用生物标志物，尤其是在血清胆红素水平较高的患者中。
