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Updated: Mar 12, 2026
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Published on: February 3, 2026
CA19-9-Low&Lewis (+) pancreatic cancer: A unique subtype
Guopei Luo1, Chen Liu1, Meng Guo1
1Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China.
Abstract:
The study was performed to identify unique subtype from the long-term survival (>24 months) patients with advanced pancreatic cancer (1039 cases). Long-term survival patients had higher proportion of low secretion of carbohydrate antigen 19-9 (CA19-9) than that of patients with non long-term survival (P < 0.001). Considering the impact of Lewis status on CA19-9 secretion, Lewis genotypes were further determined by Sanger sequencing. The prognosis of CA19-9-Low&Lewis (-) patients was worse than that of CA19-9-Low&Lewis (+) (hazard ratio (HR) = 0.37, P < 0.001). The proportion of epidermal growth factor receptor (EGFR) (-) cases was lower in the CA19-9-Low&Lewis (+) subgroup than that in other patients (P = 0.047). For the CA19-9-Low&Lewis (+) subgroup, chemotherapy plus radiotherapy but not chemotherapy was found to be an independent prognostic factor (versus best supportive care, chemotherapy, HR = 0.71, P = 0.267; chemotherapy plus radiotherapy, HR = 0.33, P = 0.022). We conclude that CA19-9-Low&Lewis (+) pancreatic cancer is a unique subtype with special biological properties.
