CA19-9与DUPAN-2联合应用于胰腺腺癌的临床效用
Clinical Utility of the Combined Use of CA19-9 and DUPAN-2 in Pancreatic Adenocarcinoma.
作者信息
Sumiyoshi Tatsuaki, Uemura Kenichiro, Shintakuya Ryuta, Okada Kenjiro, Baba Kenta, Harada Takumi, Serikawa Masahiro, Ishii Yasutaka, Nakamura Shinya, Arihiro Koji, Murakami Yoshiaki, Takahashi Shinya
机构信息
Department of Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.
Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.
出版信息
Ann Surg Oncol. 2024 Jul;31(7):4665-4672. doi: 10.1245/s10434-024-15221-z. Epub 2024 Apr 23.
PURPOSE
Pancreatic ductal adenocarcinoma (PDAC) patients with normal carbohydrate antigen (CA) 19-9 levels can have early-stage cancer or advanced cancer without elevation of CA19-9 level; estimating their malignant potential is difficult. This study investigated the clinical utility of the combined use of preoperative CA 19-9 and Duke pancreatic monoclonal antigen type 2 (DUPAN-2) levels in patients with PDAC.
METHODS
Patients who underwent curative-intent surgery for PDAC between November 2005 and December 2021 were investigated. Eligible patients were classified into four groups based on these two markers. Among patients with normal CA19-9 levels, those with normal and high DUPAN-2 levels were classified into normal/normal (N/N) and normal/high (N/H) groups, respectively. Among patients with high CA19-9 levels, those with normal and high DUPAN-2 levels were classified into high/normal (H/N) and high/high (H/H) groups, respectively. Survival rates were compared between the groups.
RESULTS
Among 521 patients, the N/N, N/H, H/N, and H/H groups accounted for 25.0%, 10.6%, 35.1%, and 29.4% of patients, respectively. The proportions of resectable PDAC in the N/N and H/N groups (71.5% and 66.7%) were significantly higher than those in the N/H and H/H groups (49.1% and 54.9%) (P < 0.01). The 5-year survival rates in the N/N, N/H, H/N, and H/H groups were 66.0%, 31.1%, 34.9%, and 29.7%, respectively; the rate in the N/N group was significantly better than those in the other three groups (P < 0.0001, P < 0.0001, and P < 0.0001, respectively).
CONCLUSIONS
Only patients with normal CA19-9 and DUPNA-2 values should be diagnosed with early-stage PDAC.
目的
糖类抗原（CA）19-9水平正常的胰腺导管腺癌（PDAC）患者可能患有早期癌症或CA19-9水平未升高的晚期癌症；评估其恶性潜能较为困难。本研究探讨了术前CA 19-9和杜克胰腺单克隆抗原2型（DUPAN-2）水平联合应用于PDAC患者的临床效用。
方法
对2005年11月至2021年12月期间接受PDAC根治性手术的患者进行调查。符合条件的患者根据这两种标志物分为四组。在CA19-9水平正常的患者中，DUPAN-2水平正常和高的患者分别分为正常/正常（N/N）组和正常/高（N/H）组。在CA19-9水平高的患者中，DUPAN-2水平正常和高的患者分别分为高/正常（H/N）组和高/高（H/H）组。比较各组的生存率。
结果
在521例患者中，N/N、N/H、H/N和H/H组分别占患者的25.0%、10.6%、35.1%和29.4%。N/N组和H/N组可切除PDAC的比例（71.5%和66.7%）显著高于N/H组和H/H组（49.1%和54.9%）（P<0.01）。N/N、N/H、H/N和H/H组的5年生存率分别为66.0%、31.1%、34.9%和29.7%；N/N组的生存率显著优于其他三组（分别为P<0.0001、P<0.0001和P<0.0001）。
结论
只有CA19-9和DUPNA-2值正常的患者才能被诊断为早期PDAC。
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