Roles of CA19-9 in pancreatic cancer: Biomarker, predictor and promoter

Biochim Biophys Acta Rev Cancer. 2021 Apr;1875(2):188409. doi: 10.1016/j.bbcan.2020.188409. Epub 2020 Aug 19.


Carbohydrate antigen 19-9 (CA19-9) is the best validated biomarker and an indicator of aberrant glycosylation in pancreatic cancer. CA19-9 functions as a biomarker, predictor, and promoter in pancreatic cancer. As a biomarker, the sensitivity is approximately 80%, and the major challenges involve false positives in conditions of inflammation and nonpancreatic cancers and false negatives in Lewis-negative Individuals. Lewis antigen status should be determined when using CA19-9 as a biomarker. CA19-9 has screening potential when combined with symptoms and/or risk factors. As a predictor, CA19-9 could be used to assess stage, prognosis, resectability, recurrence, and therapeutic efficacy. Normal baseline levels of CA19-9 are associated with long-term survival. As a promoter, CA19-9 could be used to evaluate the biology of pancreatic cancer. CA19-9 can accelerate pancreatic cancer progression by glycosylating proteins, binding to E-selectin, strengthening angiogenesis, and mediating the immunological response. CA19-9 is an attractive therapeutic target for cancer, and strategies include therapeutic antibodies and vaccines, CA19-9-guided nanoparticles, and inhibition of CA19-9 biosynthesis.

Keywords: Biology; Carbohydrate antigen 19-9; Diagnosis; Lewis; Pancreatic adenocarcinoma.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antibodies, Monoclonal
  • Antigens, Tumor-Associated, Carbohydrate / blood*
  • Biomarkers, Tumor / blood*
  • Disease Progression
  • Glycosylation
  • Humans
  • Neoplasm Staging
  • Pancreatic Neoplasms / blood
  • Pancreatic Neoplasms / pathology*


  • Antibodies, Monoclonal
  • Antigens, Tumor-Associated, Carbohydrate
  • Biomarkers, Tumor
  • PRO131921 monoclonal antibody
  • carbohydrate antigen 199, human

Supplementary concepts

  • Pancreatic Carcinoma