CA-19-9 SERUM COURSE AND PROGNOSIS OF PANCREATIC-CANCER

Conclusion, CA 19-9 measurement is a simple test that can be used for diagnosis as well as for prediction of resection, survival rate after surgery, and recurrences. Methods. Serum expression of the tumor marke r CA 19-9 was studied in 2119 patients. Results. The discriminating ca pacity between benign and malignant disease was high for CA 19-9, espe cially in patients with pancreatic cancer (n = 347). The sensitivity o f CA 19-9 was 85%. Inpatients who were Lewis blood type positive, the sensitivity increased to 92%. CA 19-9 levels were significantly lower in patients with resectable tumors (n = 126) than in those with unrese ctable tumors (n = 221, p < 0.0001) (sensitivity 74 vs 90%). CA 19-9 d ropped sharply after resection, but normalized only in 29, 13, and 10% in patients with stage I, II, and III, respectively. In unresectable tumors no significant decrease of CA 19-9 after laparotomy or bypass o peration was found. In patients of the same tumor stage, the median su rvival time in those whose CA 19-9 levels returned to normal after res ection was significantly longer than in those with postoperative CA 19 -9 levels that decreased, but did not return to normal (in stage I, 33 vs 11.3 mo, in stage II, 41 vs 8.6 mo, and in stage III, 28 vs 10.8 m o). In patients with recurrent disease, 88% had an obvious rise in CA 19-9 levels.