The value of serum carbohydrate antigen 19-9 as a predictor of resectability in pancreatic adenocarcinoma | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 34, Issue 4, October 2015 PDF (254.67 K) | ||||
| DOI: 10.4103/1110-1121.167382 | ||||
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| Authors | ||||
| Ayman A. Albatanony; Alaa A. Alseesi | ||||
| Abstract | ||||
| Background Pancreatic cancer is one of the most common causes for cancer-related deaths. Recently, considerable improvements in radiological imaging have made it possible to limit surgery for patients who will benefit. However, ~25-50% of patients with resectable disease on computed tomography (CT) are found to have unresectable lesions at laparotomy. The sensitivity and specificity of carbohydrate antigen 19-9 (CA 19-9) in the diagnosis of pancreatic cancer has been reported to be as high as 90 and 98%, respectively. However, little is known about the value of serum CA 19-9 levels in evaluating the resectability of pancreatic carcinoma. Aim of the work The aim of this study was to evaluate the value of serum CA 19-9 level in determining resectability of pancreatic cancer in comparison with triphasic CT. Patients and methods This retrospective study included 40 patients with histologically confirmed pancreatic adenocarcinomas. Serum CA 19-9 level was recorded, together with the CT findings. The operative decision as regards resectability was recorded. The level of CA 19-9 in the resectable and irresectable cases was recorded to determine a cutoff value for serum CA 19-9. Results Serum CA 19-9 in resectable cases was 182.84 219.68, whereas in irresectable cases it was: 1119.60 668.66 ( < 0.001). At a cutoff value of 307.55, the sensitivity for resection was 100%, specificity was 88.67%, positive predictive value was 71.43%, the negative predictive value was 100%, and accuracy was 90%. Conclusion Preoperative CA 19-9 serum level is a useful marker for further evaluating the resectability of pancreatic adenocarcinoma. Obviously increased serum level of CA 19-9 more than 307.55 U/ml can be regarded as a predictor for unresectable pancreatic cancer. This is beneficial in avoiding unnecessary laparotomy and preventing its morbidity. | ||||
| Keywords | ||||
| Carbohydrate Antigen 19-9; Pancreatic adenocarcinoma; resctability | ||||
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