# The relationship between serum CA50, CA242, and SAA levels and clinical pathological characteristics and prognosis in patients with pancreatic cancer

## TL;DR

This study shows that higher levels of CA50, CA242, and SAA in pancreatic cancer patients are linked to worse outcomes, and combining these markers improves prognosis prediction.

## Contribution

The study demonstrates that combined detection of CA50, CA242, and SAA significantly improves poor prognosis prediction in pancreatic cancer.

## Key findings

- High CA50, CA242, and SAA levels were significantly associated with worse survival in pancreatic cancer patients.
- Combined detection of CA50, CA242, and SAA had higher predictive accuracy than single markers for poor prognosis.
- High-expression groups of these markers showed significantly higher mortality risk.

## Abstract

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.

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.

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.

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.