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Regression Analysis for Survival Data
Published in Trevor F. Cox, Medical Statistics for Cancer Studies, 2022
From the Wald tests, Sex, Age, WHO status and Country are not significant, i.e. the HRs are not significantly different from unity. We could have looked at the significance of each factor level within those factors with more than two levels – none were significant. The significant factors are resection margin, tumour grade, lymph node status, tumour stage, maximum tumour diameter, postoperative carbohydrate antigen (CA19-9) and treatment. Note, the number of individuals with a recorded value, N, for each variable is shown. For CA19-9, , that is 65 missing values.
Case 14
Published in Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta, Clinical Cases, 2021
Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta
CA19-9 is the tumour marker most associated with hepatobiliary cancer. It has a sensitivity of approximately 80% and specificity of between 80 and 90% for pancreatic cancer. It has a low positive predictive value and is therefore not a useful screening tool. It also provides prognostic information in that levels are inversely correlated with survival.
Ten-Year History of Chronic Pancreatitis Presents with Pancreatic Head Mass
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
Courtney E. Barrows, Tara S. Kent
A 64-year-old woman with a ten-year history of chronic pancreatitis was referred for intractable abdominal pain and a new pancreatic head mass. She endorses intermittent epigastric pain and nausea over the past 18 months, resulting in worsened quality of life and several hospitalizations for pain control, a 12-pound weight loss, but no steatorrhea or diabetes. Serum CA 19-9 was normal.
Extremely high serum CA19-9 level along with elevated D-dimer in assisting detection of ruptured ovarian endometriosis
Published in Annals of Medicine, 2022
Ting Shuang, Yiran Wang, Lanbo Zhao, Kailu Zhang, Panyue Yin, Lin Guo, Wei Jing, Xue Feng, Qiling Li
Venous blood samples were collected from all patients before surgery and tested for serum CA-125 and CA19-9. Coagulation function, including plasma D-D, FIB, was also tested before surgery. Serum CA19-9 and CA-125 levels were measured using Roche electro-chemiluminescence immunoassay (Roche Co., COBAS e 602, Mannheim, Germany) with CA19-9 test Kit (Roche Co., YZB/GER 5395-2014) and CA-125 test Kit (Roche Co., YZB/GER 1568-2015), following manufacturer’s instructions. The normal reference value of CA19-9 was 0–39 U/ml, and that of CA-125 was 0–35 U/ml. Detection of D-D was performed by Latex immunoturbidimetry (SYSMEXM, CS-5100, Tokyo, Japan) using a D-D test kit(SEKISUI Co., GS1-128). The normal reference value of D-D was 0–1.0 mg/L. Those above the upper limit value were considered positive.
The role of serological biomarkers in the diagnosis and management of autoimmune pancreatitis
Published in Expert Review of Clinical Immunology, 2022
Nicolò de Pretis, Antonio Amodio, Giulia De Marchi, Eugenio Marconato, Rachele Ciccocioppo, Luca Frulloni
Finally, despite not being associated with AIP, serum carbohydrate antigen 19–9 (Ca19.9) is currently part of the diagnostic work-up of patients with suspected AIP and in patients with pancreatic lesions of unknown origin. The European Guidelines on IgG4-related digestive disease [49] encourage the use of serum Ca19.9 for the differentiation of AIP from pancreatic cancer. Ca19.9 is a cheap and simple test, and it is the best validated serum tumor marker for pancreatic cancer, having the best accuracy in patients with advanced disease[50]. Very high Ca19.9 levels have been described in AIP patients[51]. Ca19.9 should be part of the diagnostic work-up in patients with pancreatic lesions or suspected AIP. Depending on the cutoff value used, the specificity in differentiating AIP from pancreatic cancer has been reported between 73 and 96%, and the sensitivity has been reported between 56 and 84% [52,53]. In conclusion, Ca19.9 level should be integrated with other criteria to achieve or reconsider the diagnosis of AIP.
Pancreatic cancer – the past, the present, and the future
Published in Scandinavian Journal of Gastroenterology, 2022
Roland Andersson, Caj Haglund, Hanna Seppänen, Daniel Ansari
Novel biomarkers in blood and cancer tissue need to be developed and validated. By earlier detection of precursor lesions and small asymptomatic early cancers, a dramatic improvement in the 5-year survival could be expected. There is a need for diagnosis, in general, to differentiate ductal adenocarcinomas in the pancreas from non-neoplastic pancreatic lesions. The serum tumor marker CA 19-9 was discovered more than 40 years ago [22,23]. CA 19-9 is not cancer nor pancreatic cancer-specific and the sensitivity to detecting local disease is not sufficient enough. Moreover, since CA 19-9 is a sialylated Lewisa blood group antigen, those 5–10% of the Caucasian population who are Lewis negative cannot express CA 19-9 at all [24]. Thereby, there is a high demand for new biomarkers that can detect early pancreatic cancer with adequate sensitivity and specificity. Furthermore, we need prognostic markers for the stratification of pancreatic cancer patients, complementary to the traditional TNM stage. Biomarkers are also needed for monitoring patients and selecting responders to treatment, avoiding unnecessary, ineffective treatment, adverse events, and costs.