Optimize CA19-9 in detecting pancreatic cancer by Lewis and Secretor genotyping

• Published in: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] Vol. 16; no. 6; pp. 1057 - 1062
• Main Authors: Luo, Guopei, Guo, Meng, Jin, Kaizhou, Liu, Zuqiang, Liu, Chen, Cheng, He, Lu, Yu, Long, Jiang, Liu, Liang, Xu, Jin, Ni, Quanxing, Yu, Xianjun
• Format: Journal Article
• Language: English
• Published: Switzerland Elsevier B.V 01.11.2016; Elsevier Limited
• Subjects: Adenocarcinoma - diagnosis; Adenocarcinoma - genetics; Age; Biomarkers; Biomarkers, Tumor; Biosynthesis; CA-19-9 Antigen - biosynthesis; CA-19-9 Antigen - blood; Cohort Studies; Deoxyribonucleic acid; Diagnosis; Disease; DNA; Endocrinology & Metabolism; Female; FUT2; FUT3; Gastroenterology and Hepatology; Genotype; Humans; Male; Middle Aged; Mortality; Mutation; Neoplasm Staging; Pancreatic adenocarcinoma; Pancreatic cancer; Pancreatic Diseases - diagnosis; Pancreatic Diseases - genetics; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - genetics; Predictive Value of Tests; Screening; Statistical analysis; Tumors; Pancreatic adenocarcinoma; Screening; Diagnosis; FUT2; FUT3
• ISSN: 1424-3903; 1424-3911; 1424-3911
• DOI: 10.1016/j.pan.2016.09.013

Carbohydrate antigen 19-9 (CA19-9) is currently the most widely used biomarker for pancreatic cancer. It is well-known that Lewis and Secretor status can affect CA19-9 biosynthesis. This study was performed to optimize CA19-9 in detecting pancreatic cancer using Lewis and Secretor dependent cut-off values. Lewis and Secretor genotypes were determined by Sanger sequencing in a large cohort of subjects (578 cases with pancreatic cancer, 210 cases with benign pancreatic disease, 315 normal subjects). The effectiveness of CA19-9 for detecting pancreatic cancer using Lewis and Secretor group dependent cut-off values was evaluated. The Lewis (-), Mixed, and Secretor (-) groups had low, medium, and high CA19-9 biosynthesis, respectively. In Lewis (-) pancreatic cancer (all stages), CA19-9 had a sensitivity of 48.6% and a specificity of 95.9% when 1.8 U/mL was used as the cut-off value. The sensitivity of CA19-9 in detecting all stages of pancreatic cancer improved from 80.1% to 88.0% and the negative predictive value increased from 81.2% to 87.1% without compromising other values when using group dependent cut-off values. The sensitivity of CA19-9 for the detection of stage I, II pancreatic cancer increased from 76.1% to 87.2%. The value of CA19-9 in detecting pancreatic cancer was optimized by using group dependent cut-off values based on Lewis and Secretor genotypes. CA19-9 can be applied as an early detector of pancreatic cancer using group dependent cut-off values.