# Clinical Significance of Cytokeratin 19-Fragments (CYFRA 21-1), Osteopontin (OPN) and Human Epididymis Protein 4 (HE4) in Pancreatic Adenocarcinoma

## TL;DR

This study examines the clinical significance of CYFRA 21-1, OPN, and HE4 in diagnosing pancreatic cancer, finding limited diagnostic value for these biomarkers.

## Contribution

The study evaluates the potential of CYFRA 21-1, OPN, and HE4 as biomarkers for pancreatic adenocarcinoma in a clinical setting.

## Key findings

- OPN levels were higher in pancreatic cancer patients compared to controls, but it was not an independent predictor.
- CYFRA 21-1 levels were significantly higher in patients with significant weight loss before admission.
- CA 19-9 showed the highest diagnostic accuracy, while CYFRA 21-1, OPN, and HE4 did not reach clinically meaningful results.

## Abstract

Pancreatic cancer remains one of the most aggressive digestive neoplasms, especially due to late diagnosis. The aim of our study was to investigate cytokeratin-19 fragments (CYFRA 21-1), osteopontin (OPN), and human epididymis protein 4 (HE4) clinical significance in pancreatic adenocarcinoma. Our research is a single-center cross-sectional prospective study that included sixty hospitalized patients diagnosed with pancreatic adenocarcinoma and fourteen controls. CYFRA 21-1, OPN, and HE4 were tested in all participants using Luminex x MAP technology. Serum CYFRA 21-1 levels were weakly correlated with those of OPN (r = 0.302; p = 0.009), HE4 (r = 0.485; p < 0.001), and carbohydrate antigen (CA) 125 (r = 0.376; p = 0.037). Similarly to CA 19-9 and CA 125, the serum OPN levels were higher in patients with pancreatic cancer when compared to controls, 3.37 (1.84; 9.12) ng/mL versus 1.59 (1.09; 2.51) ng/mL; p = 0.003. However, in multivariate analysis, the OPN was not an independent predictor for pancreatic cancer. Further, the receiver operating characteristic (ROC) curve analysis identified CA 19-9 as the biomarker with the highest diagnostic accuracy, while CYFRA 21-1, OPN, and HE4 did not reach clinically meaningful results. Further, the CYFRA 21-1 levels were significantly higher in cases subjected to significant weight loss before admission.