Details

Autor(en) / Beteiligte

• Fahrmann, Johannes F.
• Schmidt, C. Max
• Mao, Xiangying
• Irajizad, Ehsan
• Loftus, Maureen
• Zhang, Jinming
• Patel, Nikul
• Vykoukal, Jody
• Dennison, Jennifer B.
• Long, James P.
• Do, Kim-Anh
• Zhang, Jianjun
• Chabot, John A.
• Kluger, Michael D.
• Kastrinos, Fay
• Brais, Lauren
• Babic, Ana
• Jajoo, Kunal
• Lee, Linda S.
• Clancy, Thomas E.
• Ng, Kimmie
• Bullock, Andrea
• Genkinger, Jeanine
• Yip-Schneider, Michele T.
• Maitra, Anirban
• Wolpin, Brian M.
• Hanash, Samir

Titel

Lead-Time Trajectory of CA19-9 as an Anchor Marker for Pancreatic Cancer Early Detection

Ist Teil von

• Gastroenterology (New York, N.Y. 1943), 2021-03, Vol.160 (4), p.1373-1383.e6

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• There is substantial interest in liquid biopsy approaches for cancer early detection among subjects at risk, using multi-marker panels. CA19-9 is an established circulating biomarker for pancreatic cancer; however, its relevance for pancreatic cancer early detection or for monitoring subjects at risk has not been established. CA19-9 levels were assessed in blinded sera from 175 subjects collected up to 5 years before diagnosis of pancreatic cancer and from 875 matched controls from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. For comparison of performance, CA19-9 was assayed in blinded independent sets of samples collected at diagnosis from 129 subjects with resectable pancreatic cancer and 275 controls (100 healthy subjects; 50 with chronic pancreatitis; and 125 with noncancerous pancreatic cysts). The complementary value of 2 additional protein markers, TIMP1 and LRG1, was determined. In the PLCO cohort, levels of CA19-9 increased exponentially starting at 2 years before diagnosis with sensitivities reaching 60% at 99% specificity within 0 to 6 months before diagnosis for all cases and 50% at 99% specificity for cases diagnosed with early-stage disease. Performance was comparable for distinguishing newly diagnosed cases with resectable pancreatic cancer from healthy controls (64% sensitivity at 99% specificity). Comparison of resectable pancreatic cancer cases to subjects with chronic pancreatitis yielded 46% sensitivity at 99% specificity and for subjects with noncancerous cysts, 30% sensitivity at 99% specificity. For prediagnostic cases below cutoff value for CA19-9, the combination with LRG1 and TIMP1 yielded an increment of 13.2% in sensitivity at 99% specificity (P = .031) in identifying cases diagnosed within 1 year of blood collection. CA19-9 can serve as an anchor marker for pancreatic cancer early detection applications.