Serum CA[19-9] in patients with solid pancreatic mass

This study evaluated the results and efficacy of serum CA[19-9] in determining the nature of a pancreatic solid mass in patients referred for investigation of possible malignancy. A wide variety of tumor markers have been proposed for pancreatic cancer but currently the only one with any practical usefulness for diagnosis, prognosis, and monitoring of treatment is "CA[19-9]". This present study is a single center 2 year descriptive, prospective and case series studying patients with a pancreatic solid mass. Serum CA[19-9] was checked in 159 patients .The majority of patients were male [68%] and 81% had mass in the head of pancreas. Pathologic assessment revealed 131 adenocarcinomas [82%], 10 other malignancies [6%], 7 benign lesion [4%] and was non-diagnostic in 11 cases [7%]. Mean level of this tumor marker in patients with adenocarcinoma, non-adenocarcinoma malignancy, benign and non-diagnostic pathology was 1094, 1004, 120, 259 U/ML respectively. With regarding 58 U/ML as a cutoff point; sensitivity, specificity, positive predictive value, negative predictive value and accuracy of this tumor marker for diagnosing the adenocarcinoma were 85%, 67%, 88%, 60% and 81% respectively. There was no significant relationship between Serum CA[19-9] value and histopathology of solid pancreatic mass. This marker has limited sensitivity and specificity and cannot be used as a definite diagnostic test. So the use of CA[19-9] for the differentiation of pancreatic cancer should be applied on an individual case basis, depending on the clinical situation and imaging findings

Efficacy of endoscopic ultrasound guided fine needle aspiration in patients with solid pancreatic neoplasms

Endosonography is a distinct method for evaluating the structural lesions of the gastrointestinal [GI] tract, particularly the pancreatobilliary region. This procedure has made a fundamental change in the diagnosis of pancreatic mass lesion through providing fine needle aspiration. This study aims at evaluating the results and efficacy of endoscopic ultrasound fine needle aspiration [EUS-FNA] in patients with pancreatic solid mass. The present study is an observational, prospective case series nature, evaluated patients with pancreatic solid mass referred to Imam Khomeini educational hospital in Tehran for a duration of one year since November 2010. In order to determine the false negative cases, the patients were followed-up from 6 to 12 months. EUS-FNA was conducted on all 53 patients without any complication. The majority of patients included in the study were males [68%] and 81% of patients had a mass in the head of pancreas. The result of cytopathology revealed 36 adenocarcinomas [68%], 7 other malignancies [13%], benign lesions [6%] and 7 non-diagnostic cases [13%]. The frequency of non-diagnostic results was significantly high in masses smaller than 3 cm [6 vs. 1, P < 0.002]. Patients with non-diagnostic result were younger than those with malignant cytopathology [52 +/- 7.5 vs. 66 +/- 7.5 years, P < 0.001].. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of this procedure concerning Adenocarcinoma were 88%, 100%, 100%, 70% and 90%, respectively. EUS - FNA is an effective and safe procedure in histopathologic diagnosis of pancreatic tumors. This procedure is useful in all pancreatic mass cases including resectable and non-resectable ones