CA 19-9 Level as Indicator of Early Distant Metastasis and Therapeutic Selection in Resected Pancreatic Cancer

Abstract Introduction Emerging evidence revealed the active role played by capillary morphogenesis gene 2 (CMG2) during the disease progression and metastasis of some cancers. It was shown that CMG2 was increased in pancreatic tumours in our previous research. The current study further validated this finding for the expression of CMG2 in pancreatic cancer and also dissected its clinical implication. Method Immunochemical staining of CMG2 was performed on a pancreatic cancer tissue microarray (PA2081, Biomax, n = 104). Clinical relevance of CMG2 was analysed in TCGA pancreatic cancer cohort and gene array data (GSE71729) using ANOVA and Kaplan-Meier analyses. Influence of CMG2 on adhesion to a mesothelial cell monolayer was determined using both Mia-PaCa-2 and PANC-1 cell lines with CMG2 knockdown. Result CMG2 is increased significantly in pancreatic ductal adenomas, P < 0.001 compared with adjacent non-tumour tissues. Higher levels of CMG2 were also revealed in the distant metastases of pancreatic cancer, P < 0.001 compared with both primary tumuors and distant metastasis. Elevated expression CMG2 protein in pancreatic cancers was also observed on the tissue microarray. Patients with higher CMG2 expression tumours had shorter overall survival (median = 15.8 months), P < 0.001 compared with those patients with lower CMG2 expressing tumours (median = 30.4 months). Knockdown of the CMG2 significantly decreased the number of cells which adhere to the mesothelial cells (P < 0.001). Conclusion Elevated CMG2 expression in pancreatic ductal adenocarcinomas is associated with distant metastasis and shorter survival which requires further investigation to shed light on its therapeutic potential. Take-home Message Elevated CMG2 expression in pancreatic ductal adenocarcinomas is associated with distant metastasis and shorter survival.

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Clinicopathologic characteristics, laboratory parameters, treatment protocols, and outcomes of pancreatic cancer: a retrospective cohort study of 1433 patients in China

PeerJ ◽

10.7717/peerj.4893 ◽

2018 ◽

Vol 6 ◽

pp. e4893 ◽

Cited By ~ 6

Author(s):

Shuisheng Zhang ◽

Xiaozhun Huang ◽

Yuan Tian ◽

Saderbieke Aimaiti ◽

Jianwei Zhang ◽

...

Keyword(s):

Pancreatic Cancer ◽

Cohort Study ◽

Prognostic Factors ◽

Lymph Node ◽

Distant Metastasis ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Clinicopathologic Characteristics ◽

Treatment Protocols ◽

Laboratory Parameters

Objectives The prognosis of people with pancreatic cancer is extremely unfavorable. However, the prognostic factors remain largely undefined. We aimed to perform comprehensive analyses of clinicopathologic characteristics, laboratory parameters, and treatment protocols for exploring their role as prognostic factors of pancreatic cancer. Methods Patients diagnosed with pancreatic cancer and hospitalized at the China National Cancer Center between April 2006 and May 2016 were enrolled in this retrospective cohort study. Clinicopathologic characteristics, laboratory parameters, and treatment protocols were compared among patients at different stages of the disease. The association between these factors and overall survival (OS) was analyzed using the Kaplan–Meier method and Cox proportional hazards model. Results The present study included 1,433 consecutive patients with pancreatic cancer. Median OS was 10.6 months (95% confidence interval [CI] 9.8–11.3 months), with 1-, 3-, and 5-year survival rates of 43.7%, 14.8%, and 8.8%, respectively. Cox multivariate analysis findings identified the following factors as independent predictors of OS: gender (female vs male, hazard ratio 0.72, 95% CI [0.54–0.95]); elevated total bilirubin (TBil; 1.82, 1.34–2.47); elevated carbohydrate antigen 19-9 (CA19-9; 1.72, 1.17–2.54); tumor being located in pancreatic body and tail (1.52, 1.10–2.10); advanced T stage (T3-4 vs T1-2, 1.62, 1.15–2.27); lymph node metastasis (1.57, 1.20–2.07); distant metastasis (1.59, 1.12–2.27); the presence of surgical resection (0.53, 0.34–0.81); and the presence of systemic chemotherapy (0.62, 0.45–0.82). Conclusions Being male, elevated TBil and carcinoembryonic antigen, tumor being located in pancreatic body and tail, advanced T stage, lymph node and distant metastasis, the absence of surgical resection, and the absence of systematic chemotherapy were associated with worse OS in patients with pancreatic cancer.

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