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Annals of Oncology Advance Access first published online on August 18, 2009
This version published online on September 8, 2009
Annals of Oncology, doi:10.1093/annonc/mdp332
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

review

Tumor markers in pancreatic cancer: a European Group on Tumor Markers (EGTM) status report

M. J. Duffy1,2,*, C. Sturgeon3, R. Lamerz4, C. Haglund5, V. L. Holubec6, R. Klapdor7, A. Nicolini8, O. Topolcan6 and V. Heinemann9

1 Department of Pathology and Laboratory Medicine, St Vincent's University Hospital, Dublin
2 UCD School of Medicine and Medical Science, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
3 Department of Clinical Biochemistry, Royal Infirmary of Edinburgh, Edinburgh, UK
4 Medical Klinik II, Klinikum Grosshadern, Munich, Germany
5 Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland
6 Second Department of Internal Medicine, University Hospital, Pilsen, Czech Republic
7 Centre for Clinical and Experimental Tumour Diagnosis and Therapy, Hamburg, Germany
8 Department of Internal Medicine, University of Pisa, Pisa, Italy
9 Medical Clinic III, Klinikum Grosshadern, Munich, Germany

* Correspondence to: Prof. M. J. Duffy, Nuclear Medicine Laboratory, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. Tel: +353-1-2094378; Fax: +353-1-2696018; E-mail: michael.j.duffy{at}ucd.ie

Pancreatic ductal adenocarcinoma is one of the most difficult malignancies to diagnose and treat. The aim of this article is to review how tumor markers can aid the diagnosis and management of patients with this malignancy. The most widely used and best validated marker for pancreatic cancer is CA 19-9. Inadequate sensitivity and specificity limit the use of CA 19-9 in the early diagnosis of pancreatic cancer. In non-jaundiced patients, however, CA 19-9 may complement other diagnostic procedures. In patients with resectable pancreatic cancer, presurgical and postresection CA 19-9 levels correlate with overall survival. In advanced disease, elevated pretreatment levels of CA 19-9 are associated with adverse patient outcome and thus may be combined with other factors for risk stratification. Most, but not all, reports indicate that serial levels of CA 19-9 correlate with response to systemic therapy. Use of CA 19-9 kinetics in conjunction with imaging is therefore recommended in monitoring therapy. Although several potential serum and tissue markers for pancreatic cancer are currently undergoing evaluation, none are sufficiently validated for routine clinical use. CA 19-9 thus remains the serum pancreatic cancer marker against which new markers for this malignancy should be judged.

biomarker, CA 19-9, EGTM, guidelines, pancreatic cancer, tumor markers

The name of the ninth author has been corrected.

Received for publication March 11, 2009. Revision received May 14, 2009. Accepted for publication May 15, 2009.


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