Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, largely due to late-stage diagnosis and limited therapeutic efficacy. The carbohydrate antigen 19-9 (CA19-9) is the most widely used serum biomarker in the management of PDAC. While CA19-9 has significant limitations as a screening or diagnostic tool, including low sensitivity for early-stage disease and a lack of expression in the Lewis antigen-negative population, its value in the post-diagnostic setting is well established. This review examines the production and clearance dynamics of CA19-9. It critically evaluates how these factors impact its role as a biomarker for prognosis, assessment of resectability, and real-time monitoring of therapeutic response and recurrence in patients with PDAC. We explore how the relatively short half-life and correlation with tumor burden make CA19-9 a dynamic tool for tracking disease progression and treatment efficacy, often providing insights that precede radiographic changes. This review concludes that, despite its limitations, CA19-9 remains an important, cost-effective, and widely accessible biomarker for the longitudinal management of patients with established pancreatic cancer. Its dynamic changes allow continuous real-time disease monitoring providing critical information for clinical decision-making.
胰腺导管腺癌（PDAC）因其诊断多处于晚期且治疗效果有限，目前仍是最致命的恶性肿瘤之一。碳水化合物抗原19-9（CA19-9）是PDAC临床管理中最广泛应用的血清生物标志物。尽管CA19-9作为筛查或诊断工具存在明显局限性——包括对早期病变敏感性不足以及在Lewis抗原阴性人群中无法表达，但其在确诊后的临床价值已得到充分验证。本综述系统探讨了CA19-9的生成与清除动力学机制，重点分析了这些因素如何影响其作为预后评估指标、可切除性判断标准以及PDAC患者治疗反应与复发实时监测工具的作用效能。研究表明，CA19-9较短的半衰期及其与肿瘤负荷的相关性，使其成为追踪疾病进展和治疗效果的动态监测工具，其变化往往早于影像学改变。综述最终指出，尽管存在局限性，CA19-9仍是胰腺癌患者纵向管理中重要、经济且可及性强的生物标志物，其动态变化能为临床决策提供实时连续的疾病监测信息。
肿瘤(癌症)患者之家