Evaluation of a serologic marker, CA19-9, in the diagnosis of pancreatic cancer.
OBJECTIVE
To determine the utility of the serologic marker CA19-9 in the diagnosis of pancreatic cancer in patients suspected of having a pancreatic disorder.


METHODS
Blinded study of frozen pedigreed serum samples collected at time of diagnostic evaluation with follow-up review at a mean of 8 years.


METHODS
A general university teaching hospital serving both primary and referral patient populations.


RESULTS
Sera collected prospectively from 1978 to 1980 from 261 patients undergoing imaging studies of the pancreas (ultrasound, computed tomography, endoscopic retrograde cholangiopancreatography) for a variety of symptoms were assayed for CA19-9 levels, and the results were compared with earlier determinations of other potential markers for pancreatic cancer. In 54 patients ultimately shown to have pancreatic cancer, the CA19-9 assay showed a sensitivity of 70% with a median value of 349 u/mL (normal less than 70 u/mL) and range, 7.3 to 2,859,964 u/mL, whereas specificity of the marker in this population was 87%. The positive predictive value was 59%, and the negative predictive value was 92%. Results of CA19-9 testing in the small group of patients with definitive staging information showed no difference in sensitivity between patients with local/regional disease (n = 6) and those with distant metastases (n = 14), 50% compared with 71% (P = 0.613).


CONCLUSIONS
CA19-9 was found to be a more sensitive and specific marker of pancreatic cancer than other serologic markers and should be a useful test in the patient with suspected pancreatic disease.
Pleskow
D K
DK
New England Deaconess Hospital, Boston, Massachusetts.
Berger
H J
HJ
Gyves
J
J
Allen
E
E
McLean
A
A
Podolsky
D K
DK
D000230:Adenocarcinoma / Q000276:immunology; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis*; D002272:Carcinoembryonic Antigen / Q000032:analysis; D004066:Digestive System Diseases / Q000276:immunology; D006801:Humans; D009369:Neoplasms / Q000276:immunology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000276:immunology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011863:Radioimmunoassay
D015295:Antigens, Tumor-Associated, Carbohydrate; D002272:Carcinoembryonic Antigen