CA 19-9 é o principal biomarcador sérico para adenocarcinoma ductal pancreático (PDAC) — nós...
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| ID | BMA-CA-19-9-PANCREATIC-CAPS-SURVEILLANCE |
|---|---|
| Tipo | Relevância terapêutica |
| Estado | reviewed 2026-05-18 | actionability review required |
| Doenças | DIS-PDAC |
| Fontes | SRC-CAPS-CONSORTIUM-PANCREATIC-2020 SRC-ESMO-PANCREATIC-2024 SRC-NCCN-PANCREATIC-2025 |
Fatos de ação
| Biomarcador | BIO-CA-19-9-PANCREATIC |
|---|---|
| Variante | CA 19-9 — Vigilância PDAC/monitoragem tratamento-resposta |
| Doença | DIS-PDAC |
| Nível ESCAT | IIIA |
| Combinações recomendadas | Aumento CA 19-9 + novos achados EUS / MRCP em portador de alto risco: refere-se ao centro multidisciplinar de pâncreas para biópsia / estadiamento, Resposta ao tratamento: declínio CA 19-9 >50% por meio do tratamento apoia a continuação; aumento apesar da terapêutica → reposição |
| Resumo das provas | 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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