Effectiveness of multivariate analysis of tumor markers in diagnosis of pancreatic carcinoma: a prospective study in multiinstitutions.
In 403 patients suspected of having pancreatic cancer, we prospectively studied a combination assay of various serum tumor markers: CA19-9, DUPAN2, tissue polypeptide antigen, elastase 1, gamma-glutamyltranspeptidase, lactate dehydrogenase, lipase, amylase, and alkaline phosphatase. The diagnostic value of each marker was compared with a multivariate analysis (computer-aided multivariate and pattern analysis system for pancreatic cancer examine-1: CAMPAS-PX1). Pancreatic cancer was subsequently identified in 47 patients. CAMPAS-PX1 had higher negative in health and positive predictability than those of each marker used alone in the diagnosis of pancreatic cancer. CAMPAS-PX1 proved the most effective marker for diagnosing pancreatic cancer, but in terms of its cost/benefit ration CAMPAS-PX1 was not superior to CA19-9 used alone. In this prospective trial, we experienced poor generalizability in the statistical models (CAMPAS-PX1). We believe that selection bias was present in samples used for model building. Based on this study a new model has been designed.
Kuno
N
N
Department of Internal Medicine, Aichi Cancer Center, Nagoya, Japan.
Kurimoto
K
K
Fukushima
M
M
Hayakawa
T
T
Shibata
T
T
Suzuki
T
T
Sakakibara
A
A
Katada
N
N
Nakano
S
S
Takayama
T
T
D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D000681:Amylases / Q000097:blood; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood; D003936:Diagnosis, Computer-Assisted; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008049:Lipase / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010196:Pancreatic Elastase / Q000097:blood; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D010455:Peptides / Q000097:blood; D011446:Prospective Studies; D012372:ROC Curve; D012044:Regression Analysis; D015203:Reproducibility of Results; D019396:Tissue Polypeptide Antigen
D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D010455:Peptides; D019396:Tissue Polypeptide Antigen; D007770:L-Lactate Dehydrogenase; D008049:Lipase; D000469:Alkaline Phosphatase; D000681:Amylases; D010196:Pancreatic Elastase