Tumor Markers CA19-9, CA242 and CEA in the Diagnosis of Pancreatic Cancer: a Meta-analysis

Background: Pancreatic cancer has the worst prognosis and early detection is crucial for improving patient prognosis. Therefore, we performed a meta-analysis to evaluate and compare the sensitivity and specificity of single test of CA19-9, CA242, and CEA, as well as combination test in pancreatic cancer detection.

Methods: We searched PubMed, Embase, Medline, and Wanfang databases for studies that evaluated the diagnostic validity of CA19-9, CA242, and CEA between January 1990 and September 2014. Data were analyzed by Meta-Disc and STATA software.

Results: A total of 21 studies including 3497 participants, which fulfilled the inclusion criteria were considered for analysis. The pooled sensitivities for CA19-9, CA242, and CEA were 75.4 (95% CI: 73.4-77.4), 67.8 (95% CI: 65.5-70), and 39.5 (95% CI: 37.3-41.7), respectively. The pooled specificities of CA19-9, CA242, and CEA were 77.6 (95% CI: 75.4-79.7), 83 (95% CI: 81-85), and 81.3 (95% CI: 79.3-83.2), respectively. Parallel combination of CA19-9+CA242 has a higher sensitivity (89, 95% CI: 80-95) without impairing the specificity (75, 95% CI: 67-82).

Conclusions: Our meta-analysis showed that CA242 and CA19-9 have better performance in the diagnosis of pancreatic cancer than CEA. Furthermore, parallel combination test of CA19-9+CA242 could be of better diagnostic value than individual CA242 or CA19-9 test.