Abstract
Carbohydrate antigen 72-4 (CA72-4) is a human tumor-associated glycoprotein, commonly used as a tumor marker for diagnosing and predicting outcome in gastric and ovarian cancers. However, the relationship between serum CA72-4 levels and prognosis of pancreatic adenocarcinoma has not been fully elucidated. A total of 113 consecutive locally advanced pancreatic adenocarcinoma patients who underwent intensity-modulated radiation therapy (IMRT) with or without chemotherapy were enrolled in this study. Serum CA72-4 levels were analyzed using immunoenzymometric assays. The association between serum CA72-4 levels and prognosis was evaluated. Serum CA72-4 levels was related with lymph node metastasis (P<0.001). The median overall survival time was 14.0 months for patients with serum CA72-4 normal levels and 10.0 months for the elevated levels (P<0.001). Multivariate analysis identified that Serum CA72-4 concentration was a significant prognostic factor (P<0.001). The hazard ratio (HR) of elevated serum CA72-4 levels compared with normal serum CA72-4 levels was 2.34 (95% confidence interval [CI]: 1.46-3.73), after adjusted for gender and age. Based on this finding, Serum CA72-4 is a potential marker to predict lymph node metastasis and prognosis in pancreatic adenocarcinoma.
Highlights
Pancreatic adenocarcinoma is one of the most extremely malignant neoplasms in both developing and developed countries
We examined the overall survival differences of patients stratified for normal Carbohydrate antigen 72-4 (CA72-4) levels and elevated CA72-4 levels according to regional lymph node metastasis
We find that elevated pre-treatment serum CA72-4 levels are associated with poorer prognosis in pancreatic adenocarcinoma patients receiving intensity-modulated radiation therapy (IMRT)
Summary
Pancreatic adenocarcinoma is one of the most extremely malignant neoplasms in both developing and developed countries. A great number of pancreatic adenocarcinoma patients experienced disease progression in a very short time. Due to poor early diagnosis, only 13-20% of patients are at stage I at the time of diagnosis. For locally advanced pancreatic adenocarcinoma, combined or sequential chemotherapy and radiotherapy is the standard method [2, 3]. Chemoradiation therapy displays a modest survival benefit compared with radiotherapy or chemotherapy alone [4, 5]. Some patients with similar clinical stage have remarkably different survival prognosis. In this way, heterogeneity of protein expression profiles may play a very important role in the development of pancreatic adenocarcinoma [6]. To date, most of these markers had not been proven to be sufficiently effective [7]
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