Accuracy of preoperative serum CA19-9 levels in predicting the resectability of patients with pancreatic adenocarcinoma

Abstract

Abstract Objective To assess the accuracy of preoperative serum CA19-9 levels in predicting the resectability of pancreatic adenocarcinoma. Methods Patients with biopsy-proven pancreatic adenocarcinoma who had preoperative serum CA19-9 level data were enrolled in the present retrospective analysis. Receiver operating characteristics (ROC) curve analysis was used to determine the optimal cut-off value of CA19-9. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated at this cut-off point. Results Seventy-six patients with pancreatic adenocarcinoma that was considered potentially resectable according to radiological imaging were included. Of all 76 patients, 44 received complete resection of the pancreatic adenocarcinoma. The preoperative serum CA19-9 level was significantly higher in the unresectable tumor group than in the resectable tumor group (P = 0.0036). The area under the ROC curve was 0.749 (95% confidence interval [CI]: 0.637-0.842). When the cut-off value of CA19-9 was set to 359.1 U/mL, the sensitivity, specificity, positive and negative predictive values were 71.9% (95% CI: 53.3%-86.3%), 70.5% (95% CI: 54.8%-83.2%), 63.9% (95% CI: 46.0%-79.4%), and 77.5% (95% CI: 61.5%-89.2%), respectively. Conclusion The preoperative serum CA19-9 level is useful for predicting the resectability of pancreatic adenocarcinoma.