Abstract
OBJECTIVE: This study aimed to investigate the relationship between serum carbohydrate antigen 50 (CA50), carbohydrate antigen 242 (CA242), and serum amyloid A (SAA) levels and clinical pathological features and prognosis in pancreatic cancer (PC) patients. METHODS: A total of 163 PC patients were divided into a survival group (n = 43) and a deceased group (n = 120). Serum levels of CA50, CA242, and SAA were measured, and patients were categorized into high- and low-expression groups based on median values. Relationships between marker expression, clinical features, and prognosis were analyzed using Cox regression, receiver operating characteristic (ROC) analysis, and Kaplan-Meier curves. RESULTS: Serum CA50, CA242, and SAA levels were significantly higher in the deceased group than in the survival group (all P < 0.001). High CA50 was linked to advanced TNM stage and distant metastasis; high CA242 to advanced TNM stage and lower differentiation; and high SAA to advanced TNM stage and distant metastasis (all P < 0.05). Multivariate Cox regression showed that advanced TNM stage (hazard ratio [HR] = 1.499, 95% confidence interval [CI] = 1.003-2.238, P = 0.048), distant metastasis (HR = 1.693, 95% CI = 1.157-2.478, P = 0.007), high CA50 (HR = 1.041, 95% CI = 1.019-1.064, P < 0.001), high CA242 (HR = 1.044, 95% CI = 1.018-1.070, P < 0.001), and high SAA (HR = 1.096, 95% CI = 1.044-1.151, P < 0.001) were independent risk factors for poor prognosis. ROC analysis showed that the combined detection of CA50, CA242, and SAA had the highest predictive value for poor prognosis (AUC = 0.989, sensitivity = 93.33%, specificity = 100%), which was significantly superior to single-marker detection (CA50: AUC = 0.872, sensitivity = 78.33%, specificity = 88.37%; CA242: AUC = 0.905, sensitivity = 74.17%, specificity = 88.37%; SAA: AUC = 0.871, sensitivity = 80.00%, specificity = 83.72%; all P < 0.001 vs combination). Kaplan-Meier curves revealed higher mortality risk in high-expression groups. CONCLUSION: Serum CA50, CA242, and SAA levels are closely associated with PC patients' clinical features and prognosis. Their combined detection is a valuable tool for assessing poor prognosis in PC.