Significant increased CA199 levels in acute pancreatitis patients predicts the presence of pancreatic cancer.

Dongling Teng,Weijuan Gong,Weiqin Li,Guotao Lu,Dan Wang,Keyan Wu,Tao Yin,Yunyun Sun,Yanbing Ding,Min Zhang,Jian Wu,Weiming Xiao

doi:10.18632/oncotarget.23993

Abstract

Background and study aimsCarbohydrate antigen 19-9 (CA199) has been identified as a tumor marker for pancreatic cancer but also increases in benign lesions of the digestive system. However, literature associated with the relationship between CA199 and acute pancreatitis (AP) is limited. This study aimed to focus on serum CA199 level measurements in AP patients and the associated clinical significance.Materials and methodsFrom January 2006 to December 2015, 1,609 consecutive patients with AP were admitted to our department and included in the study. The relationships among the etiology of AP, the disease severity, the incidence of pancreatic cancer during hospitalization and CA199 levels were analyzed.ResultsSerum CA199 levels were measured for 693 of 1,609 AP patients. Of those patients, 186 (26.8%) had elevated CA199 levels (> 37 U/ml). Patients with high CA199 levels were older and had predominantly biliary causes in comparison with patients with normal CA199 levels. There were no definite specific correlations between CA199 levels and disease severity in AP. In addition, serum levels of CA199 positively correlated with serum alanine aminotransferase, aspartate transaminase, glutamyl transpeptidase, alkaline phosphatase and creatinine levels. After stratification, the incidence of pancreatic cancer increased proportionally to CA199 levels in AP patients.ConclusionsSerum CA199 levels was elevated in patients with AP, especially in patients with biliary pancreatitis. AP patients with significantly increased CA199 levels may have a higher risk for the presence of pancreatic cancer. We recommended routinely monitoring CA199 levels during hospitalization for AP patients.

Highlights

Acute pancreatitis (AP) is characterized by pancreatic tissue self-digestion, edema, hemorrhage and even necrosis caused by the inflammatory responses next to trypsin activation
This study aimed to focus on serum Carbohydrate antigen 19-9 (CA199) level measurements in acute pancreatitis (AP) patients and the associated clinical significance
Serum CA199 levels was elevated in patients with AP, especially in patients with biliary pancreatitis

Summary

Introduction

Acute pancreatitis (AP) is characterized by pancreatic tissue self-digestion, edema, hemorrhage and even necrosis caused by the inflammatory responses next to trypsin activation. The signs and symptoms of AP include pain in the upper abdomen, nausea, vomiting, fever and increased serum amylase levels. AP has multiple etiologies [2, 3], and the most common causes include gallstones, heavy alcohol consumption and hypertriglyceridemia. Other minor causes include pancreatic duct obstruction, surgery and www.impactjournals.com/oncotarget trauma, endocrine and metabolic disorders, infections, drugs, genetic factors and so on. Many pancreatic cancer patients may be misdiagnosed as AP, even delaying their diagnosis and treatment [9, 10]. Carbohydrate antigen 19-9 (CA199) has been identified as a tumor marker for pancreatic cancer and increases in benign lesions of the digestive system. This study aimed to focus on serum CA199 level measurements in AP patients and the associated clinical significance

Objectives

Methods

Results

Conclusion