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A sugar molecule shed into the blood by most pancreatic cancers; useful to follow treatment, not to screen.
Sialyl-Lewis A carbohydrate antigen elevated in ~80% of PDAC; 5-10% of people (Lewis-negative) cannot make it. Prognostic at diagnosis, tracks response and recurrence, and defines eligibility in trials. Too non-specific for population screening (raised in biliary obstruction, pancreatitis), but glycan-engineered variants and combination with cfDNA are under study for high-risk surveillance.
Showing the technology this term belongs to: High-risk pancreatic surveillance (CAPS / PRECEDE).
A very low CA 19-9 is not reassurance: it marks the non-producer group whose outlook matches the highest-marker group, and it gives clinics a rule they can apply without genotyping.
The current honest statement of where early detection stands: no blood test is ready, and the research is about finding the threshold at which to operate.
Together with the JCO Precision Oncology cohort this makes residual disease testing in biliary cancer prognostic to the same degree as in colon cancer. Nobody has yet shown that acting on it helps; that is the trial gap the ideas on this page name.
Fixes the window in which a blood test could plausibly work and shows why CA 19-9 alone is not enough: half of early cases are missed even at diagnosis, and Lewis-negative patients are missed entirely.
It quantifies how little DNA an operable pancreatic cancer sheds and why every serious early detection panel pairs DNA with proteins.
It stops CA 19-9 response being used as a trial endpoint or as the reason to change treatment, while leaving baseline level as a prognostic factor.
The numbers that keep CA 19-9 a monitoring and prognostic marker rather than a diagnostic or screening test.
The reason a normal CA 19-9 never rules pancreatic cancer out, why Lewis-negative patients need a different marker (CA 125, CEA or CA 19-9-independent panels), and a constraint on every blood-based detection idea on this page.
Shares Blood-based pancreatic cancer detection in new-onset diabetes, Run the ENDPAC score on every new diabetes diagnosis after 50 and scan the high scorers, Lead-Time Trajectory of CA19-9 as an Anchor Marker for Pancreatic Cancer Early Detection, High-risk pancreatic surveillance (CAPS / PRECEDE).
Shares Resectability classes for pancreatic cancer (NCCN anatomical criteria and the 2017 international consensus), High-risk stigmata and worrisome features of pancreatic cysts (IPMN and MCN surgical criteria), Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Borderline resectable pancreatic ductal adenocarcinoma.
Shares Ampullary cancer (ampulla of Vater), Borderline resectable pancreatic ductal adenocarcinoma, Extrahepatic cholangiocarcinoma (perihilar and distal), Locally advanced unresectable pancreatic ductal adenocarcinoma.
Shares High-risk stigmata and worrisome features of pancreatic cysts (IPMN and MCN surgical criteria), Ampullary cancer (ampulla of Vater), Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Locally advanced unresectable pancreatic ductal adenocarcinoma.
Shares Lewis-negative (Lewis antigen-negative, CA 19-9 non-secretor) status, New-onset diabetes as a signal of pancreatic cancer (and the ENDPAC score), Blood-based pancreatic cancer detection in new-onset diabetes, Run the ENDPAC score on every new diabetes diagnosis after 50 and scan the high scorers.
Shares Blood-based pancreatic cancer detection in new-onset diabetes, Run the ENDPAC score on every new diabetes diagnosis after 50 and scan the high scorers, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question, The hardest cancers are found late.
Shares Pancreatic cancer early detection biomarkers for high-risk individuals: insights from the PRECEDE consortium, High-risk pancreatic surveillance (CAPS / PRECEDE), Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question.
Shares Systematic review of carbohydrate antigen (CA 19-9) as a biochemical marker in the diagnosis of pancreatic cancer, Biliary tract cancer (cholangiocarcinoma), Gallbladder cancer, Pancreatic ductal adenocarcinoma.