Purpose: It is suggested that tumour markers carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) could be used to predict the stage of pancreatic cancer. However, optimal cut-off values for CEA and CA19-9 are disputable. This study aimed to assess the value of CEA and CA19-9 serum levels at diagnosis of pancreatic ductal adenocarcinoma (PDAC) as predictors for the advanced stage of PDAC in patients discussed at pancreatic multidisciplinary team (MDT) meetings.Methods: Patients with suspected PDAC discussed at MDT meetings from 2013 to 2017 were reviewed, in order to determine optimal cut-off values of both CEA and CA19-9.Results: In total, 375 patients were included. Optimal cut-off values for predicting advanced PDAC were 7.0 ng/ml for CEA and 305.0 U/ml for CA19-9, resulting in positive predictive values of 83.3%, 73.6%, and 91.4% for CEA, CA19-9 and combined, respectively. Both tumour markers were independent predictors of advanced PDAC, demonstrated by an odds ratio of 4.21 (95% CI:1.85-9.56; p = 0.001) for CEA and 2.58 for CA19-9 (95% CI:1.30-5.14; p = 0.007).Conclusions: CEA appears to be a more robust predictor of advanced PDAC than CA19-9. Implementing CEA and CA19-9 serum levels during MDT meetings as an additional tool for establishing tumour resectability is worthwhile for tailored diagnostics.

中文翻译：

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确诊时，CEA和CA19-9血清水平升高可独立预测晚期胰腺癌。

目的：提示肿瘤标志物癌胚抗原（CEA）和糖抗原19-9（CA19-9）可用于预测胰腺癌的分期。但是，CEA和CA19-9的最佳临界值是有争议的。这项研究旨在评估CEA和CA19-9血清水平在诊断胰腺导管腺癌（PDAC）中的价值，作为胰腺多学科小组（MDT）会议上讨论的患者PDAC晚期的预测指标。回顾了2013年至2017年在MDT会议上讨论的内容，以确定CEA和CA19-9的最佳分界值。结果：共纳入375名患者。预测晚期PDAC的最佳临界值对于CEA为7.0 ng / ml，对于CA19-9为305.0 U / ml，得出阳性预测值为83.3％，73.6％和91。CEA，CA19-9和CAA分别为4％。两种肿瘤标志物都是晚期PDAC的独立预测因子，CEA的比值比为4.21（95％CI：1.85-9.56; p = 0.001），CA19-9的比值比为2.58（95％CI：1.30-5.14; p = 0.007）结论：CEA似乎比CA19-9更可靠地预测高级PDAC。在MDT会议期间将CEA和CA19-9血清水平作为确定肿瘤可切除性的附加工具值得进行定制的诊断。