Diagnostic Value of VEGF, CA 19-9, and CEA in Pancreatic Cancer and Risk Factors of Vascular Invasion
Download PDF
$currentUrl="http://$_SERVER[HTTP_HOST]$_SERVER[REQUEST_URI]"

Keywords

Pancreatic cancer
Tumor markers
Vascular endothelial growth factor
Carcinoembryonic antigen
Carbohydrate antigen 19-9

DOI

10.26689/jcnr.v7i2.4723

Submitted : 2023-02-28
Accepted : 2023-03-15
Published : 2023-03-30

Abstract

Background: Pancreatic cancer is a malignant tumor of the gastrointestinal tract. Due to its insidious onset, most patients with newly diagnosed pancreatic cancer have missed the opportunity for radical surgery, which offers patients the best chance of survival. The 5-year survival rate of patients with pancreatic cancer can be improved with early diagnosis, and serum tumor makers are an inexpensive and convenient diagnostic tool that is widely used in the diagnosis of malignancies. Objective: To determine the diagnostic value of vascular endothelial growth factor (VEGF), carbohydrate antigen 19-9 (CA 19-9), and carcinoembryonic antigen (CEA) in patients with pancreatic cancer and the risk factors of vascular invasion. Methods: An experimental group comprising 52 patients with pancreatic cancer admitted to our department from July 2021 to July 2022 and a control group comprising 21 patients with benign pancreatic diseases during the same period were included in our study. Their serum VEGF, CA 19-9, and CEA levels were detected and compared between the two groups, and the correlation between the three markers in the invaded vessel and non-invaded vessel groups was investigated. The diagnostic value of a single tumor marker and in combination for pancreatic cancer was analyzed, and the three tumor marker levels of the experimental group in different pathological characteristics were detected and compared. Results: The experimental group had higher serum VEGF, CA 19-9, and CEA levels than the control group (P < 0.05). Through a receiver operating characteristic (ROC) curve analysis, the combined detection had the highest value for the diagnosis of pancreatic cancer, in which the area under the curve (AUC) was 0.9158 (95% CI: 0.8415–0.9900), while the sensitivity and specificity were 76.19% and 98.08%, respectively. Serum VEGF and CA 19-9 levels were higher in stage III–IV pancreatic cancer patients and those with tumor metastasis compared with stage I–II patients and those without metastasis (P < 0.05), respectively. Binary logistic regression analysis was performed to determine the risk factors of vascular invasion in pancreatic cancer, and the results showed that only serum VEGF was a risk factor (P < 0.05), OR (95% CI): 1.001–1.006. Conclusion: Patients with pancreatic cancer have significantly higher serum VEGF, CA 19-9, and CEA levels, and the combined detection of tumor markers is of high clinical value in its diagnosis. In addition, serum VEGF is an independent risk factor of vascular invasion in pancreatic cancer, which can predict vascular invasion to a certain extent.

References

McGuire GS, 2016, Switzerland: World Health Organization, International Agency for Research on Cancer, WHO Press, 2015. Advances in Nutrition an International Review Journal, 7(2): 418–419.

Wolfgang CL, Herman JM, Laheru DA, et al., 2013, Recent Progress in Pancreatic Cancer. A Cancer Journal for Clinicians, 63(5): 318–348.

Rahib L, Smith BD, Aizenberg R, et al., 2014, Projecting Cancer Incidence and Deaths to 2030: The Unexpected Burden of Thyroid, Liver, and Pancreas Cancers in the United States. Cancer Research, 74(14): 2913–2921.

Siegel RL, Miller KD, Dvm AJ, et al., 2017, Cancer Statistics, 2017. A Cancer Journal for Clinicians, 67(1): 7–30.

Gao M, Xu J, Yang W, 2020, Research Progress on Tumor Markers for Early Diagnosis of Pancreatic Cancer. Tumor Research and Clinic, 12: 881–884.

Ren S, Tang H, Wang Z, 2019, Research Progress of Tumor Markers in the Diagnosis of Pancreatic Cancer. Modern Oncology, 3: 512–515.

Cheng Y, Wang K, Geng L, et al., 2019, Identification of Candidate Diagnostic and Prognostic Biomarkers for Pancreatic Carcinoma. EBioMedicine, 40: 382–393.

Goonetilleke KS, Siriwardena AK, 2007, Systematic Review of Carbohydrate Antigen (CA 19-9) as a Biochemical Marker in the Diagnosis of Pancreatic Cancer. European Journal of Surgical Oncology, 33(3): 266–270.

Su SB, Qin SY, Chen W, et al., 2015, Carbohydrate Antigen 19-9 for Differential Diagnosis of Pancreatic Carcinoma and Chronic Pancreatitis. World Journal of Gastroenterology, 21(14): 4323–4333.

Kerbel RS, 2008, Tumor Angiogenesis. New England Journal of Medicine, 358(19): 2039–2049.

Ferrara N, Adamis AP, 2016, Ten Years of Anti-Vascular Endothelial Growth Factor Therapy. Nature Reviews Drug Discovery, 15(6): 385–403.

Hammarstr MS, 1999, The Carcinoembryonic Antigen (CEA) Family: Structures, Suggested Functions and Expression in Normal and Malignant Tissues. Seminars in Cancer Biology, 9(2): 67–81.

Sobierajska K, Ciszewski WM, Sacewicz-Hofman I, et al., 2020, Endothelial Cells in the Tumor Microenvironment. Advances in Experimental Medicine and Biology, 1234: 71–86.