Clinical Trials Study
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World J Gastroenterol. May 21, 2014; 20(19): 5875-5880
Published online May 21, 2014. doi: 10.3748/wjg.v20.i19.5875
Prognostic significance of SUVmax and serum carbohydrate antigen 19-9 in pancreatic cancer
Jian-Guo Zhao, Ya Hu, Quan Liao, Zhe-Yu Niu, Yu-Pei Zhao
Jian-Guo Zhao, Ya Hu, Quan Liao, Zhe-Yu Niu, Yu-Pei Zhao, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Author contributions: Liao Q and Zhao YP designed research; Zhao JG and Niu ZY performed research; Hu Y analyzed data; Zhao JG wrote the paper.
Supported by Fundamental Research Funds for the Central Universities of China, No. 2012N01
Correspondence to: Quan Liao, MD, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1 Shuai Fu Yuan Hu Tong, Beijing 100730, China. lqpumc@126.com
Telephone: +86-10-69156007 Fax: +86-10-69156007
Received: December 24, 2013
Revised: February 11, 2014
Accepted: March 6, 2014
Published online: May 21, 2014
Abstract

AIM: To investigate the prognostic significance of pretreatment standardized maximum uptake value (SUVmax) and serum carbohydrate antigen (CA)19-9 in pancreatic cancer.

METHODS: From January 2007 to October 2011, 80 consecutive patients with pancreatic cancer who received positron emission/computed tomography before any treatment were enrolled in this study. The pretreatment SUVmax and CA19-9 level of the primary pancreatic tumor were obtained and compared with clinicopathological and prognostic factors. Student’s t test for unpaired data was used to analyze the differences between two groups. Univariate analysis and Cox proportional hazards regression were used to examine the independent effects of each significant variable. Survival was analyzed by the Kaplan-Meier method.

RESULTS: There was a significant correlation between both the SUVmax and serum CA19-9 of pancreatic cancer and R0 surgical resection (P = 0.043 and P = 0.007). Lymph node metastasis was associated with SUVmax (P = 0.017), but not serum CA19-9 (P = 0.172). On the contrary, the tumor stage was significantly related to serum CA19-9 (P = 0.035), but not SUVmax (P = 0.110). The univariate analysis showed that survival time was significantly related to tumor stage (P < 0.001), lymph node metastasis (P = 0.043), R0 surgical resection (P < 0.001), serum CA19-9 (P = 0.001), SUVmax (P < 0.001) and SUVmax plus CA19-9 (P = 0.002). Multivariate analysis clearly showed that only tumor stage (hazard ratio = 0.452; P = 0.020) was an independent prognostic factor for overall survival in pancreatic cancer. Higher SUVmax or CA19-9 showed worse prognosis. We found that high serum CA19-9 plus SUVmax was the most significant variable.

CONCLUSION: Higher pretreatment SUVmax and serum CA19-9 indicates poor prognosis. SUVmax plus serum CA19-9 is the most significant variable in predicting survival.

Keywords: Pancreatic cancer, Maximum standardized uptake value, Carbohydrate antigen 19-9, Prognostic factors

Core tip: We investigated the clinicopathological characteristics and prognostic significance of standardized maximum uptake value (SUVmax) of pancreatic cancer and serum carbohydrate antigen (CA)19-9. Higher SUVmax or CA19-9 showed worse prognosis, and high serum CA19-9 plus SUVmax was the most significant variable in predicting survival.