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

ABSTRACT

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: