diagnostic and prognostic performance of microrna-25, carbohydrate antigen 19-9, carcinoembryonic antigen, and carbohydrate antigen 125 in pancreatic ductal adenocarcinoma

Background: pancreatic cancer is a malignancy with high mortality due to the difficulties in early detection. we investigated and compared the diagnostic and prognostic performance of several blood biomarkers, including microrna-25 (mir-25), carbohydrate antigen 19-9 (ca19-9), carcinoembryonic antigen (cea), and carbohydrate antigen 125 (ca125). methods: a retrospective study was conducted at the chinese people’s liberation army general hospital from may 2014 to september 2018. serum specimens were collected, and mir-25 expression levels were measured using real-time quantitative polymerase chain reaction. serum ca19-9, cea, and ca125 levels were measured using enzyme-linked immunosorbent assay (elisa). statistical analyses including nonparametric test, receiver operator characteristic (roc) curves, kaplan-meier analysis, and subsequent log-rank test were performed with prism 5.0 software. univariate and multivariate analyses were performed with the r software. p<0.05 was considered statistically significant.results: a total of 250 individuals were recruited, including 75 with pancreatic ductal adenocarcinoma (pdac), 75 with benign lesions, and 100 healthy controls. mir-25, ca19-9, cea, and ca125 exhibited an area under the curve (auc) of 0.88, 0.91, 0.81, and 0.76 with a sensitivity of 78.7%, 74.7%, 37.3%, and 35.7% and specificity of 91.5%, 97.0%, 98.2%, and 98.3%, respectively. the combination of mir-25 and ca19-9 further increased the sensitivity to 93.3% with a specificity of 88.5%. stage-dependent sensitivity was observed with ca19-9, cea, and ca125. mir-25 levels significantly stratified the prognosis by median level (4,989.97 copies/ml). ca19-9, cea, and ca125 levels significantly stratified the prognosis by median levels. univariate and subsequent multivariate analyses identified tumor (t) stage, ca19-9, and ca125 as independent risk factors for pdac prognosis.conclusion: the combination of mir-25 and ca19-9 significantly enhanced the detection sensitivity of pdac. t stage, ca19-9, and ca125 levels were independent risk factors for pdac prognosis.