CA 19-9 es el principal biomarcador sérico para el adenocarcinoma ductal pancreático (PDAC)...
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| ID | BMA-CA-19-9-PANCREATIC-CAPS-SURVEILLANCE |
|---|---|
| Tipo | Relevancia terapéutica |
| Situación | reviewed 2026-05-18 | actionability review required |
| Enfermedades | DIS-PDAC |
| Fuentes | SRC-CAPS-CONSORTIUM-PANCREATIC-2020 SRC-ESMO-PANCREATIC-2024 SRC-NCCN-PANCREATIC-2025 |
Hechos relativos a la posibilidad de adoptar medidas
| Biomarcador | BIO-CA-19-9-PANCREATIC |
|---|---|
| Variante | CA 19-9 — Vigilancia PDAC / seguimiento de la respuesta al tratamiento |
| Enfermedad | DIS-PDAC |
| El nivel de ESCAT | IIIA |
| Combinaciones recomendadas | Rising CA 19-9 + new EUS / MRCP findings in high-risk carrier: refer to multidisciplinary pancreas centre for biopsy / staging, Treatment response: declining CA 19-9 >50% by mid-treatment supports continuation; rising despite therapy → restage |
| Resumen de las pruebas | CA 19-9 is the principal serum biomarker for pancreatic ductal adenocarcinoma (PDAC) — used for (a) prognosis at diagnosis, (b) treatment response monitoring (declining CA 19-9 during neoadjuvant / systemic therapy correlates with PFS / OS — Tempero 2024), and (c) longitudinal surveillance in high-risk germline carriers per the CAPS Consortium 2020 (CDKN2A, BRCA1/2, PALB2, ATM, STK11, MMR with positive FH; PRSS1 mutation with hereditary pancreatitis). CA 19-9 is NOT useful for population screening — high false-positive rate and Lewis-antigen-negative non-secretors (~5-10%) lack the epitope. In the CAPS surveillance pathway, rising CA 19-9 combined with EUS/MRI findings triggers further workup. ESCAT IIIA. |
Notas
STUB pending two-Co-Lead signoff. Hereditary-PDAC surveillance Indication entities for CAPS-cohort syndromes (CDKN2A/FAMMM, BRCA1/2, PALB2, ATM, Lynch, STK11, hereditary pancreatitis) are partially authored — closest existing entities: ind_brca_carrier_surveillance, ind_fammm_carrier_surveillance, ind_lynch_carrier_surveillance. A dedicated IND-CAPS-COHORT-SURVEILLANCE entity (consolidating the trigger criteria across syndromes) is a future authoring task. Lewis-antigen-negative status (~5-10% of population) yields false-negative CA 19-9 — this should be flagged in the patient profile to avoid false reassurance. Engine should not surface CA 19-9 < ULN as "negative" without Lewis status known.
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