CA-125, but not galectin-3, complements CA 19-9 for discriminating ductal adenocarcinoma versus non-malignant pancreatic diseases.

Abstract

BACKGROUND/OBJECTIVES:

CA 19-9 is the gold standard biomarker of pancreatic adenocarcinoma despite several weaknesses in particular a high rate of false positives or negatives. CA-125 corresponding to MUC16 and galectin-3, a lectin able to interact with mucin-associated carbohydrates, are tumor-associated proteins. We investigated whether combined measurement of CA 19-9, galectin-3 and CA-125 may help to better discriminate pancreatic adenocarcinoma versus non-malignant pancreatic diseases.

METHODS:

We evaluated by immunohistochemistry the expression of MUC4, MUC16 (CA-125) and galectin-3 in 31 pancreatic adenocarcinomas. We measured CA 19-9, CA-125 and Gal-3 in the serum from patients with pancreatic benign diseases (n = 58) or adenocarcinoma (n = 44). Clinical performance of the 3 biomarkers for cancer diagnosis and prognosis was analyzed.

RESULTS:

By immunohistochemistry, MUC16 and Gal-3 were expressed in 74% and 84% of adenocarcinomas versus 0% and 3.2% in peri-tumoral regions, respectively. At the serum level, CA 19-9 and CA125 were significantly higher in patients with pancreatic adenocarcinoma whereas Gal-3 levels did not differ. The performance of CA 19-9 for cancer detection was higher than those of CA-125 or Gal-3 by ROC analysis. However, CA-125 offers the highest specificity for malignancy (81%) because of an absence of false positives among type 2 diabetic patients. Cancer deaths assessed 6 or 12 months after diagnosis varied according to the initial CA-125 level (p < 0.006).

CONCLUSION:

Gal-3 is not an interesting biomarker for pancreatic adenocarcinoma detection. CA 19-9 alone exhibits the best performance but measuring CA-125 provides complementary information in terms of diagnosis and prognosis.

• Authors: Lucie Coppin, Kanza Benomar, François Corfiotti, Stéphane Cattan, Florence Renaud, Camille Lapere, Emmanuelle Leteurtre, Marie-Christine Vantyghem, Stéphanie Truant, Pascal Pigny
• Journal: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] (Pancreatology) 2016 Jan-Feb Vol. 16 Issue 1 Pg. 115-20 ISSN: 1424-3911 [Electronic] Switzerland
• PMID: 26613889 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 IAP and EPC. Published by Elsevier India Pvt Ltd. All rights reserved.

Chemical References

• Blood Proteins
• CA-125 Antigen
• CA-19-9 Antigen
• Galectin 3
• Galectins
• LGALS3 protein, human
• MUC16 protein, human
• MUC4 protein, human
• Membrane Proteins
• Mucin-4

Topics

• Adult
• Aged
• Aged, 80 and over
• Blood Proteins
• CA-125 Antigen (blood, genetics, metabolism)
• CA-19-9 Antigen (blood, genetics, metabolism)
• Female
• Galectin 3 (blood, genetics, metabolism)
• Galectins
• Gene Expression Regulation, Neoplastic (physiology)
• Humans
• Male
• Membrane Proteins (genetics, metabolism)
• Middle Aged
• Mucin-4 (genetics, metabolism)
• Pancreatic Neoplasms (diagnosis, metabolism)
• Survival Analysis