Prognostic Role of Preoperative Duke Pancreatic Monoclonal Antigen Type 2 Levels in Patients with Pancreatic Cancer.
CA19-9
DUPAN-2
Pancreatic cancer
Prognosis
Journal
Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
20
12
2022
accepted:
09
04
2023
medline:
11
8
2023
pubmed:
30
5
2023
entrez:
29
5
2023
Statut:
ppublish
Résumé
This study aimed to evaluate the clinical implication of Duke pancreatic monoclonal antigen type 2 (DUPAN-2) for patients with pancreatic cancer (PC), especially those with normal carbohydrate antigen (CA) 19-9 levels. The study reviewed 224 patients who underwent surgery for PC from January 2003 through December 2019 at the Shizuoka Cancer Center. The patients were divided into three groups according to the following CA19-9 and DUPAN-2 levels: normal CA19-9/normal DUPAN-2, normal CA19-9/high DUPAN-2, and high CA19-9. The prognostic utility of the DUPAN-2 levels in the normal CA19-9 patients was investigated. Elevated serum levels of DUPAN-2 were observed in 29 (25.2%) of the normal CA19-9 patients. The cutoff value for serum DUPAN-2 level was set at 250 U/ml. Both disease-free survival and disease-specific survival (DSS) in the normal CA19-9/high DUPAN-2 group were significantly shorter than in the normal CA19-9/normal DUPAN-2 group and comparable with those in the high CA19-9 group. In the normal CA19-9 group, DUPAN-2 was identified as an independent prognostic factor for DSS. The patients with normal CA19-9/high DUPAN-2 had higher pathologic malignancy than the patients with normal CA19-9/normal DUPAN-2, which was comparable with that in the patients with high CA19-9. In PC, DUPAN-2 may be useful as a biomarker complementary with CA19-9. The combination of these two markers may aid in the preoperative prediction of prognosis for patients with PC.
Sections du résumé
BACKGROUND
BACKGROUND
This study aimed to evaluate the clinical implication of Duke pancreatic monoclonal antigen type 2 (DUPAN-2) for patients with pancreatic cancer (PC), especially those with normal carbohydrate antigen (CA) 19-9 levels.
METHODS
METHODS
The study reviewed 224 patients who underwent surgery for PC from January 2003 through December 2019 at the Shizuoka Cancer Center. The patients were divided into three groups according to the following CA19-9 and DUPAN-2 levels: normal CA19-9/normal DUPAN-2, normal CA19-9/high DUPAN-2, and high CA19-9. The prognostic utility of the DUPAN-2 levels in the normal CA19-9 patients was investigated.
RESULTS
RESULTS
Elevated serum levels of DUPAN-2 were observed in 29 (25.2%) of the normal CA19-9 patients. The cutoff value for serum DUPAN-2 level was set at 250 U/ml. Both disease-free survival and disease-specific survival (DSS) in the normal CA19-9/high DUPAN-2 group were significantly shorter than in the normal CA19-9/normal DUPAN-2 group and comparable with those in the high CA19-9 group. In the normal CA19-9 group, DUPAN-2 was identified as an independent prognostic factor for DSS. The patients with normal CA19-9/high DUPAN-2 had higher pathologic malignancy than the patients with normal CA19-9/normal DUPAN-2, which was comparable with that in the patients with high CA19-9.
CONCLUSION
CONCLUSIONS
In PC, DUPAN-2 may be useful as a biomarker complementary with CA19-9. The combination of these two markers may aid in the preoperative prediction of prognosis for patients with PC.
Identifiants
pubmed: 37248377
doi: 10.1245/s10434-023-13564-7
pii: 10.1245/s10434-023-13564-7
doi:
Substances chimiques
CA-19-9 Antigen
0
Antigens, Neoplasm
0
Biomarkers, Tumor
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5792-5800Informations de copyright
© 2023. Society of Surgical Oncology.
Références
Miller KD, Nogueira L, Mariotto AB, et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin. 2019;69:363–85.
doi: 10.3322/caac.21565
pubmed: 31184787
Katz MH, Wang H, Fleming JB, et al. Long-term survival after multidisciplinary management of resected pancreatic adenocarcinoma. Ann Surg Oncol. 2009;16:836–47.
doi: 10.1245/s10434-008-0295-2
pubmed: 19194760
pmcid: 3066077
Uesaka K, Boku N, Fukutomi A, et al. Adjuvant chemotherapy of S-1 versus gemcitabine for resected pancreatic cancer: a phase 3, open-label, randomised, non-inferiority trial (JASPAC 01). Lancet. 2016;388:248–57.
doi: 10.1016/S0140-6736(16)30583-9
pubmed: 27265347
Kindler HL. A Glimmer of hope for pancreatic cancer. N Engl J Med. 2018;379:2463–4.
doi: 10.1056/NEJMe1813684
pubmed: 30575492
Tempero MA, Malafa MP, Al-Hawary M, et al. Pancreatic adenocarcinoma, version 2.2021, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2021;19:439–57.
doi: 10.6004/jnccn.2021.0017
pubmed: 33845462
Sugiura T, Uesaka K, Kanemoto H, et al. Serum CA19-9 is a significant predictor among preoperative parameters for early recurrence after resection of pancreatic adenocarcinoma. J Gastrointest Surg. 2012;16:977–85.
doi: 10.1007/s11605-012-1859-9
pubmed: 22411488
La Greca G, Sofia M, Lombardo R, et al. Adjusting CA19-9 values to predict malignancy in obstructive jaundice: influence of bilirubin and C-reactive protein. World J Gastroenterol. 2012;18:4150–5.
doi: 10.3748/wjg.v18.i31.4150
pubmed: 22919247
pmcid: 3422795
Narimatsu H, Iwasaki H, Nakayama F, et al. Lewis and secretor gene dosages affect CA19-9 and DU-PAN-2 serum levels in normal individuals and colorectal cancer patients. Cancer Res. 1998;58:512–8.
pubmed: 9458099
Orntoft TF, Vestergaard EM, Holmes E, et al. Influence of Lewis alpha1-3/4-L-fucosyltransferase (FUT3) gene mutations on enzyme activity, erythrocyte phenotyping, and circulating tumor marker sialyl-Lewis a levels. J Biol Chem. 1996;271:32260–8.
doi: 10.1074/jbc.271.50.32260
pubmed: 8943285
Watkins WM. Biochemistry and genetics of the ABO, Lewis, and P blood group systems. Adv Hum Genet. 1980;10:1–136.
pubmed: 6156588
Network NCC. NCCN clinical practice guidelines in oncology: pancreatic adenocarcinoma version 2.2022, December 6, 2022. https://www.nccn.org/professionals/physician_gls/pdf/pancreatic.pdf . Accessed 26 Mar 2023.
Luo G, Liu C, Guo M, et al. CA19-9-Low&Lewis (+) pancreatic cancer: a unique subtype. Cancer Lett. 2017;385:46–50.
doi: 10.1016/j.canlet.2016.10.046
pubmed: 27840089
Luo G, Fan Z, Cheng H, et al. New observations on the utility of CA19-9 as a biomarker in Lewis-negative patients with pancreatic cancer. Pancreatology. 2018;18:971–6.
doi: 10.1016/j.pan.2018.08.003
pubmed: 30131287
Kwon S, Kim S, Giovannucci EL, et al. Lewis antigen phenotype and survival of patients with pancreatic cancer. Pancreas. 2020;49:1348–54.
doi: 10.1097/MPA.0000000000001687
pubmed: 33122524
Okada K, Kawai M, Tani M, et al. Predicting factors for unresectability in patients with pancreatic ductal adenocarcinoma. J Hepatobiliary Pancreat Sci. 2014;21:648–53.
doi: 10.1002/jhbp.109
pubmed: 24764208
Shibata K, Iwaki K, Kai S, Ohta M, Kitano S. Increased levels of both carbohydrate antigen 19–9 and Duke pancreatic monoclonal antigen type 2 reflect postoperative prognosis in patients with pancreatic carcinoma. Pancreas. 2009;38:619–24.
doi: 10.1097/MPA.0b013e3181a53ee7
pubmed: 19436235
Kawa S, Tokoo M, Oguchi H, et al. Epitope analysis of SPan-1 and DUPAN-2 using synthesized glycoconjugates sialyllact-N-fucopentaose II and sialyllact-N-tetraose. Pancreas. 1994;9:692–7.
doi: 10.1097/00006676-199411000-00003
pubmed: 7531332
Omiya K, Oba A, Inoue Y, et al. Serum DUPAN-2 could be an alternative biological marker for CA19-9 non-secretors with pancreatic cancer. Ann Surg. 2022. https://doi.org/10.1097/SLA.0000000000005395 .
doi: 10.1097/SLA.0000000000005395
pubmed: 35081567
Mazumdar M, Glassman JR. Categorizing a prognostic variable: review of methods, code for easy implementation and applications to decision-making about cancer treatments. Stat Med. 2000;19:113–32.
doi: 10.1002/(SICI)1097-0258(20000115)19:1<113::AID-SIM245>3.0.CO;2-O
pubmed: 10623917
Motoi F, Ishida K, Fujishima F, et al. Neoadjuvant chemotherapy with gemcitabine and S-1 for resectable and borderline pancreatic ductal adenocarcinoma: results from a prospective multi-institutional phase 2 trial. Ann Surg Oncol. 2013;20:3794–801.
doi: 10.1245/s10434-013-3129-9
pubmed: 23838925
Toyama H, Sugiura T, Fukutomi A, et al. Randomized phase II trial of chemoradiotherapy with S-1 versus combination chemotherapy with gemcitabine and S-1 as neoadjuvant treatment for resectable pancreatic cancer (JASPAC 04). J Clin Oncol. 2020;38(4 Suppl):724–724.
doi: 10.1200/JCO.2020.38.4_suppl.724
Ielpo B, Duran H, Diaz E, et al. Preoperative treatment with gemcitabine plus nab-paclitaxel is a safe and effective chemotherapy for pancreatic adenocarcinoma. Eur J Surg Oncol. 2016;42:1394–400.
doi: 10.1016/j.ejso.2016.01.006
pubmed: 26899943
Katz MH, Shi Q, Ahmad SA, et al. Preoperative modified FOLFIRINOX treatment followed by capecitabine-based chemoradiation for borderline resectable pancreatic cancer: alliance for clinical trials in oncology trial A021101. JAMA Surg. 2016;151:e161137.
doi: 10.1001/jamasurg.2016.1137
pubmed: 27275632
pmcid: 5210022
Takahashi S, Ohno I, Ikeda M, et al. Neoadjuvant S-1 with concurrent radiotherapy followed by surgery for borderline resectable pancreatic cancer: a phase II open-label multicenter prospective trial (JASPAC05). Ann Surg. 2022;276:e510–7.
doi: 10.1097/SLA.0000000000004535
pubmed: 33065644
Sugiura T, Uesaka K, Ohmagari N, Kanemoto H, Mizuno T. Risk factor of surgical site infection after pancreaticoduodenectomy. World J Surg. 2012;36:2888–94.
doi: 10.1007/s00268-012-1742-6
pubmed: 22907393
Sugiura T, Uesaka K, Mihara K, et al. Margin status, recurrence pattern, and prognosis after resection of pancreatic cancer. Surgery. 2013;154:1078–86.
doi: 10.1016/j.surg.2013.04.015
pubmed: 23973112
Sugiura T, Okamura Y, Ito T, Yamamoto Y, Uesaka K. Surgical indications of distal pancreatectomy with celiac axis resection for pancreatic body/tail cancer. World J Surg. 2017;41:258–66.
doi: 10.1007/s00268-016-3670-3
pubmed: 27473130
Brierley JD, Gospodarowicz M, Wittekind C. TNM classification of malignant tumours. 8th edn. New York: Wiley Blackwell; 2017.
Oettle H, Neuhaus P, Hochhaus A, et al. Adjuvant chemotherapy with gemcitabine and long-term outcomes among patients with resected pancreatic cancer: the CONKO-001 randomized trial. JAMA. 2013;310:1473–81.
doi: 10.1001/jama.2013.279201
pubmed: 24104372
Kanda Y. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant. 2013;48:452–8.
doi: 10.1038/bmt.2012.244
pubmed: 23208313
Nakashio T, Narita T, Sato M, et al. The association of metastasis with the expression of adhesion molecules in cell lines derived from human gastric cancer. Anticancer Res. 1997;17:293–9.
pubmed: 9066667
Sato M, Narita T, Kimura N, et al. The association of sialyl Lewis(a) antigen with the metastatic potential of human colon cancer cells. Anticancer Res. 1997;17:3505–11.
pubmed: 9413195
Ugorski M, Laskowska A. Sialyl Lewis(a): a tumor-associated carbohydrate antigen involved in adhesion and metastatic potential of cancer cells. Acta Biochim Pol. 2002;49:303–11.
doi: 10.18388/abp.2002_3788
pubmed: 12362971
Weston BW, Hiller KM, Mayben JP, et al. Expression of human alpha(1,3)fucosyltransferase antisense sequences inhibits selectin-mediated adhesion and liver metastasis of colon carcinoma cells. Cancer Res. 1999;59:2127–35.
pubmed: 10232599