Lead-Time Trajectory of CA19-9 as an Anchor Marker for Pancreatic Cancer Early Detection
dc.contributor.author | Fahrmann, Johannes F. | |
dc.contributor.author | Schmidt, C. Max | |
dc.contributor.author | Mao, Xiangying | |
dc.contributor.author | Irajizad, Ehsan | |
dc.contributor.author | Loftus, Maureen | |
dc.contributor.author | Zhang, Jinming | |
dc.contributor.author | Patel, Nikul | |
dc.contributor.author | Vykoukal, Jody | |
dc.contributor.author | Dennison, Jennifer B. | |
dc.contributor.author | Long, James P. | |
dc.contributor.author | Do, Kim-Anh | |
dc.contributor.author | Zhang, Jianjun | |
dc.contributor.author | Chabot, John A. | |
dc.contributor.author | Kluger, Michael D. | |
dc.contributor.author | Kastrinos, Fay | |
dc.contributor.author | Brais, Lauren | |
dc.contributor.author | Babic, Ana | |
dc.contributor.author | Jajoo, Kunal | |
dc.contributor.author | Lee, Linda S. | |
dc.contributor.author | Clancy, Thomas E. | |
dc.contributor.author | Ng, Kimmie | |
dc.contributor.author | Bullock, Andrea | |
dc.contributor.author | Genkinger, Jeanine | |
dc.contributor.author | Yip-Schneider, Michele T. | |
dc.contributor.author | Maitra, Anirban | |
dc.contributor.author | Wolpin, Brian M. | |
dc.contributor.author | Hanash, Samir | |
dc.contributor.department | Surgery, School of Medicine | en_US |
dc.date.accessioned | 2021-02-23T19:14:43Z | |
dc.date.available | 2021-02-23T19:14:43Z | |
dc.date.issued | 2021 | |
dc.description.abstract | Background & Aims There is substantial interest in liquid biopsy approaches for cancer early detection among subjects at risk, using multi-marker panels. CA19-9 is an established circulating biomarker for pancreatic cancer; however, its relevance for pancreatic cancer early detection or for monitoring subjects at risk has not been established. Methods CA19-9 levels were assessed in blinded sera from 175 subjects collected up to 5 years before diagnosis of pancreatic cancer and from 875 matched controls from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. For comparison of performance, CA19-9 was assayed in blinded independent sets of samples collected at diagnosis from 129 subjects with resectable pancreatic cancer and 275 controls (100 healthy subjects; 50 with chronic pancreatitis; and 125 with noncancerous pancreatic cysts). The complementary value of 2 additional protein markers, TIMP1 and LRG1, was determined. Results In the PLCO cohort, levels of CA19-9 increased exponentially starting at 2 years before diagnosis with sensitivities reaching 60% at 99% specificity within 0 to 6 months before diagnosis for all cases and 50% at 99% specificity for cases diagnosed with early-stage disease. Performance was comparable for distinguishing newly diagnosed cases with resectable pancreatic cancer from healthy controls (64% sensitivity at 99% specificity). Comparison of resectable pancreatic cancer cases to subjects with chronic pancreatitis yielded 46% sensitivity at 99% specificity and for subjects with noncancerous cysts, 30% sensitivity at 99% specificity. For prediagnostic cases below cutoff value for CA19-9, the combination with LRG1 and TIMP1 yielded an increment of 13.2% in sensitivity at 99% specificity ( P = .031) in identifying cases diagnosed within 1 year of blood collection. Conclusion CA19-9 can serve as an anchor marker for pancreatic cancer early detection applications. | en_US |
dc.eprint.version | Author's manuscript | en_US |
dc.identifier.citation | Fahrmann, J. F., Schmidt, C. M., Mao, X., Irajizad, E., Loftus, M., Zhang, J., Patel, N., Vykoukal, J., Dennison, J. B., Long, J. P., Do, K.-A., Zhang, J., Chabot, J. A., Kluger, M. D., Kastrinos, F., Brais, L., Babic, A., Jajoo, K., Lee, L. S., … Hanash, S. (2021). Lead-Time Trajectory of CA19-9 as an Anchor Marker for Pancreatic Cancer Early Detection. Gastroenterology. https://doi.org/10.1053/j.gastro.2020.11.052 | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/25273 | |
dc.language.iso | en | en_US |
dc.publisher | Elsevier | en_US |
dc.relation.isversionof | 10.1053/j.gastro.2020.11.052 | en_US |
dc.relation.journal | Gastroenterology | en_US |
dc.rights | Publisher Policy | en_US |
dc.source | Author | en_US |
dc.subject | biomarker | en_US |
dc.subject | detection | en_US |
dc.subject | pancreatic cancer | en_US |
dc.title | Lead-Time Trajectory of CA19-9 as an Anchor Marker for Pancreatic Cancer Early Detection | en_US |
dc.type | Article | en_US |