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Is CA125 a Better Marker than CA 19-9 for Resectability in Pancreatic Cancer ?

Color this finding: curious (and consequently interesting).

Chinese researchers in Shanghai including Yu and colleagues at Fudan University published recent research findings in the December 2013 issue of the Journal of Gastrointestinal Surgery, the official periodical of the Society for Surgery of the Alimentary Tract.  They reviewed the results of a number of potential serum tumor markers in 212 patients with confirmed pancreatic cancer (ductal adenocarcinoma of the pancreas).

The aim of the work was to establish which marker could be of best use in predicting which patients were found at an early enough stage of pancreatic cancer to be potentially eligible for surgery.  The markers under study included alpha-fetoprotein (AFP), carcinoembryonic antigen CEA), CA19-9, CA50, CA125, CA242, and CA724.

Based on past work one might have predicted the superior marker to be CA 19-9. But in fact, CA125 (often elevated in ovarian cancer) proved superior for this specific task. The selected cut-off value was 19/7 U/mL, which gave a respectable Receiver Operating Characteristic (ROC) area of 0.81.  (The ROC area of CA 19-9 with a cut-off of 289.4 U/mL was only 0.66).

We are not sure where to go with this result.  But a first step would be to substantiate it.  One might imagine that perhaps as a part of a panel – this could potentially be useful.   It would be interesting to see how CA125 tracks with early and advanced stages of pancreatic cancer.

More here


Dale O’Brien, MD