CA19-9 serum has been suggested as a marker of unresectability but different cut-off levels have been published. A cut-off of 500 U/ml is currently considered in an international consensus as biological criteria of borderline resectable pancreatic adenocarcinoma. To evaluate whether serum CA19-9 threshold of 500 U/ml could be adequate predictor of resectability in pancreatic adenocarcinoma. Multicenter, observational, prospective study performed in Spain including 203 patients diagnosed with pancreatic adenocarcinoma. 43 (21.2%) cases were resectable and 160 (78.8%) unresectable. Among the 176 preoperative CA19-9 available values, 98 (58.3%) were ≤ 500 U/ml and 73 (42.7%) > 500 U/ml. Resectability rate in those patients with CA19-9 ≤ 500 U/ml was 60% while it was found to be 18% when CA19-9 > 500 U/ml. Statistical model to predict resectability based on CA19-9 provide an AUC of 0.6618 (95% CI 0.53-0.83) when only CA19-9 values > 500 U/ml are studied. Serum levels of CA19-9 higher than 500 U/ml are indicative of unresectable disease, however reduced sensitivity and specificity lead to a limited clinical applicability for resectability.

中文翻译：

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CA19-9能力可预测西班牙队列中胰腺癌的可切除性。

有人建议将CA19-9血清作为不可切除的标志物，但已公布了不同的临界水平。目前，在国际共识中，临界值500 U / ml被认为是临界可切除胰腺癌的生物学标准。要评估血清CA19-9阈值500 U / ml是否足以预测胰腺癌的可切除性。在西班牙进行的多中心，观察性和前瞻性研究包括203例诊断为胰腺腺癌的患者。可切除的病例为43（21.2％），不可切除的病例为160（78.8％）。在176例术前CA19-9可用值中，有98（58.3％）≤500 U / ml和73（42.7％）> 500 U / ml。CA19-9≤500 U / ml的患者的可切除性率为60％，而CA19-9> 500 U / ml的可切除率为18％。当仅研究CA19-9值> 500 U / ml时，基于CA19-9预测可切除性的统计模型提供的AUC为0.6618（95％CI 0.53-0.83）。血清CA19-9高于500 U / ml表示无法切除疾病，但是敏感性和特异性降低导致可切除性的临床适用性有限。