The clinical utility of CA 19-9 in pancreatic adenocarcinoma: diagnostic and prognostic updates.
The clinical utility of CA 19-9 in pancreatic adenocarcinoma: diagnostic and prognostic updates.
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DOI：
10.2174/1566524011313030003
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发表时间：
2013-03
影响因子：
2.5
通讯作者：
Mulvihill SJ
中科院分区：
文献类型：
--
作者：
Poruk KE;Gay DZ;Brown K;Mulvihill JD;Boucher KM;Scaife CL;Firpo MA;Mulvihill SJ
CA19-9和CEA是诊断和治疗胰腺癌最常用的生物标志物。自1990年Steinberg最初发表纲要以来，已有大量研究报道了CA19-9和CEA在胰腺癌诊断中的应用。在这里，我们更新了对CA19-9和CEA准确性的评估，并与以前的审查不同，重点放在恶性和良性疾病之间的区别上，而不是正常对照。在涉及3285例胰腺癌的57项研究中，CA19-9的联合敏感度为78.2%，在37项涉及1,882例胰腺良性疾病的研究中，CA19-9的特异度为82.8%。综合分析CEA报道，敏感性为44.2%(1,324例)，特异性为84.8%(656例)。这些测量更恰当地反映了在壶腹周围疾病的鉴别诊断中预期的生物标记物的准确性。我们还总结了CA19-9作为一种预后工具的使用，并在10年的单一机构经验中评估了CA19-9诊断和预后的实用性。
CA 19-9 and CEA are the most commonly used biomarkers for diagnosis and management of patients with pancreatic cancer. Since the original compendium by Steinberg in 1990, numerous studies have reported the use of CA 19-9 and, to a lesser extent, CEA in the diagnosis of pancreatic cancer. Here we update an evaluation of the accuracy of CA 19-9 and CEA, and, unlike previous reviews, focus on discrimination between malignant and benign disease instead of normal controls. In 57 studies involving 3,285 pancreatic carcinoma cases, the combined sensitivity of CA 19-9 was 78.2% and in 37 studies involving 1,882 cases with benign pancreatic disease the specificity of CA 19-9 was 82.8%. From the combined analysis of studies reporting CEA, the sensitivity was 44.2% (1,324 cases) and the specificity was 84.8% (656 cases). These measurements more appropriately reflect the expected biomarker accuracy in the differential diagnosis of patients with periampullary diseases. We also present a summary of the use of CA 19-9 as a prognostic tool and evaluate CA 19-9 diagnostic and prognostic utility in a 10-year, single institution experience.