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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jun 21, 2008; 14(23): 3750-3753
Published online Jun 21, 2008. doi: 10.3748/wjg.14.3750
Clinical value of serum CA19-9 levels in evaluating resectability of pancreatic carcinoma
Shun Zhang, Yi-Ming Wang, Chuan-Dong Sun, Yun Lu, Li-Qun Wu
Shun Zhang, Yi-Ming Wang, Chuan-Dong Sun, Yun Lu, Li-Qun Wu, Department of Hepatobiliary Surgery, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, Shandong Province, China
Author contributions: Zhang S designed the study; Wang YM collected and analyzed the data; Wang YM wrote the paper; Sun CD, Lu Y and Wu LQ revised the paper.
Correspondence to: Shun Zhang, Department of Hepatobiliary Surgery, Affiliated Hospital of Medical College, Qingdao University, No. 16 Jiangsu Road, Qingdao 266003, Shandong Province, China. wym0066@sina.com
Telephone: +86-532-82911369
Fax: +86-532-82911999
Received: February 29, 2008
Revised: April 30, 2008
Accepted: May 7, 2008
Published online: June 21, 2008
Abstract

AIM: To evaluate the clinical value of serum CA19-9 levels in predicting the respectability of pancreatic carcinoma according to receiver operating characteristic (ROC) curve analysis.

METHODS: Serum CA19-9 levels were measured in 104 patients with pancreatic cancer which were possible to be resected according to the imaging. ROC curve was plotted for the CA19-9 levels. The point closest to the upper left-hand corner of the graph were chosen as the cut-off point. The sensitivity, specificity, positive and negative predictive values of CA19-9 at this cut-off point were calculated.

RESULTS: Resectable pancreatic cancer was detected in 58 (55.77%) patients and unresectable pancreatic cancer was detected in 46 (44.23%) patients. The area under the ROC curve was 0.918 and 95% CI was 0.843-0.992. The CA19-9 level was 353.15 U/mL, and the sensitivity and specificity of CA19-9 at this cut-off point were 93.1% and 78.3%, respectively. The positive and negative predictive value was 84.38% and 90%, respectively.

CONCLUSION: Preoperative serum CA19-9 level is a useful marker for further evaluating the resectability of pancreatic cancer. Obviously increased serum levels of CA19-9 (> 353.15 U/mL) can be regarded as an ancillary parameter for unresectable pancreatic cancer.

Keywords: Pancreatic carcinoma, Resection, Tumor markers, CA19-9, Receiver operating characteristic curve