OncoTargets and Therapy (Sep 2017)

Diagnostic and prognostic value of carcinoembryonic antigen in pancreatic cancer: a systematic review and meta-analysis

  • Meng Q,
  • Shi S,
  • Liang C,
  • Liang D,
  • Xu W,
  • Ji S,
  • Zhang B,
  • Ni Q,
  • Xu J,
  • Yu X

Journal volume & issue
Vol. Volume 10
pp. 4591 – 4598

Abstract

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Qingcai Meng,1–3,* Si Shi,1–3,* Chen Liang,1–3,* Dingkong Liang,1–3 Wenyan Xu,1–3 Shunrong Ji,1–3 Bo Zhang,1–3 Quanxing Ni,1–3 Jin Xu,1–3 Xianjun Yu1–3 1Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, 2Department of Oncology, Shanghai Medical College, 3Pancreatic Cancer Institute, Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: Carcinoembryonic antigen (CEA) is one of the most widely used tumor markers and is increased in 30%–60% of patients with pancreatic cancer. Although carbohydrate antigen 19-9 (CA19-9) is the most important serum biomarker in pancreatic cancer, the diagnostic and prognostic value of CEA is gradually being recognized.Materials and methods: The MEDLINE, EMBASE, and Web of Science databases were searched for related literature published until January 2017. Diagnostic accuracy variables were pooled using the Meta-Disc software. The pooled hazard ratios (HRs) for prognostic data were calculated and analyzed using Stata software.Results: A total of 3,650 participants enrolled in 19 studies met our inclusion criteria. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of a CEA-based panel were 0.45 (95% confidence interval [CI], 0.41–0.50), 0.89 (95% CI, 0.86–0.91), 5.39 (95% CI, 3.16–9.18), and 0.55 (95% CI, 0.41–0.72), respectively. The area under the curve (AUC, 0.90) and Q-value (0.84) of the CEA-based panel indicated a significantly higher diagnostic accuracy compared with CEA or CA19-9 alone. Moreover, there was also a significant association between high levels of CEA and worse overall survival (HR, 1.43; 95% CI, 1.31–1.56).Conclusion: Our meta-analysis indicated that elevated serum CEA level, as a vital supplementary to CA19-9, can play an important role in the clinical diagnosis of pancreatic cancer patients and predict poor prognosis. Keywords: carcinoembryonic antigen, pancreatic cancer, diagnosis, prognosis, meta-analysis

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