Elevated levels of CA 19-9 and CEA in pancreatic cancer-associated diabetes

The relationship between diabetes and pancreatic cancer has been established by more than several decades of research. However, serum levels of CEA and CA 19-9 in diabetic pancreatic cancer has not been shown. Preoperative serum levels of CEA and CA 19-9 and clinicopathological characteristics were retrospectively analyzed in 79 with or 229 without diabetes in pancreatic ductal adenocarcinoma (PDA) patients. Of the 308 PDA patients enrolled, 79 (25.6%) patients had diabetes. The percentage of new-onset diabetes (i.e. < 24 months in duration) was 57% (45/79) in PDA patients coupled with diabetes. Among diabetic PDA patients, mean total bilirubin and fasting blood glucose significantly increased in comparison with control groups (8.54 +/- A 14.88 vs. 4.16 +/- A 6.12; 170.22 +/- A 106.96 vs. 95.84 +/- A 15.76; P < 0.05). No significant differences were observed in mean levels of serum CA 19-9 and CEA levels between two groups. However, when the value of CEA and CA 19-9 was analyzed as a dichotomous variable, elevated CEA (a parts per thousand yen5 ng/ml) and CA 19-9 (a parts per thousand yen500 U/ml) levels were strongly correlated with the presence of diabetes in PDA patients. Elevated CEA (a parts per thousand yen5 ng/ml) and CA19-9 (a parts per thousand yen500 U/ml) levels have an association with diabetic pancreatic cancer. New-onset diabetes combined with higher CA 19-9 and/or CEA might be regarded as a useful tool to screen early pancreatic cancer.