Abstract
Carbohydrate antigen (CA) 19-9 is the only diagnostic marker used in pancreatic cancer despite its limitations. Here, we aimed to identify the diagnostic role of CEMIP (also called KIAA1199) combined with CA 19-9 in patients with pancreatic cancer. A retrospective analysis of prospectively collected patient samples was performed to determine the benefit of diagnostic markers in the diagnosis of pancreatic cancer. We investigated CEMIP and CA 19-9 levels in 324 patients with pancreatic cancer and 49 normal controls using serum enzyme-linked immunosorbent assay. Median CA 19-9 and CEMIP levels were 410.5 U/ml (40.8–3342.5) and 0.67 ng/ml (0.40–1.08), respectively, in patients with pancreatic cancer. The AUROC for CA 19-9 and CEMIP were 0.847 (95% confidence interval [CI]: 0.806–0.888) and 0.760 (95% CI: 0.689–0.831), respectively. Combination of CA 19-9 with CEMIP showed markedly improved AUROC over CA 19-9 alone in pancreatic cancer diagnosis (0.94 vs. 0.89; P < 0.0001). CEMIP showed a diagnostic yield of 86.1% (68/79) in CA 19-9 negative pancreatic cancer. Combined use with CEMIP showed significantly improved diagnostic value compared with CA 19-9 alone in pancreatic cancer. Especially, CEMIP may be a complementary marker in pancreatic cancer patients with normal CA 19-9 levels.
Highlights
Pancreatic cancer is a highly malignant tumor with a poor prognosis
This study describes a novel biomarker, cell migration-inducing hyaluronan binding protein (CEMIP), which may be used in combination with carbohydrate antigen (CA) 19-9 in whole blood in the diagnosis of pancreatic cancer
Combining CA 19-9 with CEMIP increased the area under the ROC curve (AUROC) compared with CA 19-9 alone in all groups
Summary
Pancreatic cancer is a highly malignant tumor with a poor prognosis. Most patients (80%) present with inoperable advanced pancreatic cancer at the time of initial diagnosis[1]. Previous studies have suggested alternative biomarkers to compensate for the limitations of CA 19-9 in patients with pancreatic cancer[7,8,9]. Several studies have investigated the role of CEMIP in pancreatic cancer; CEMIP has been reported to be associated with early detection, cancer cell migration, invasion, and poor prognosis in previous studies[10,16,17]. There have been no studies investigating the diagnostic accuracy of serum CA 19-9 in combination with CEMIP for pancreatic cancer, as compared with serum CA19-9 alone. We aimed to investigate the differences in CEMIP expression in whole blood between patients with pancreatic cancer and healthy participants, and to identify the role of CEMIP compared with that of CA 19-9 in the diagnosis of pancreatic cancer
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