Diagnosis of pancreatic cancer and prediction of unresectability using the tumor-associated antigen CA19-9.
Marked elevations of the tumor-associated antigen CA19-9 are relatively specific for pancreatic carcinoma and are associated with more advanced malignancies. We retrospectively reviewed 53 patients with CA19-9 values > 90 U/ml in whom the test had been done because of clinical suspicion of pancreatic malignancy. Pancreatic cancer was found in 45 patients (85%). If a cutoff value of CA19-9 > 200 U/ml is used, 36 of 37 (97%) patients had pancreatic cancer. Thirty patients with pancreatic cancer and no radiographic criteria of unresectability underwent attempted resection; five of these patients were judged to be potentially resectable and four of them underwent attempted resection. In only one patient with a CA19-9 value > 300 U/ml was resection possible; this patient had advanced carcinoma. Our results suggest that, in patients in whom the clinician suspects pancreatic carcinoma, CA19-9 > 90 U/ml is highly suggestive of pancreatic malignancy, while CA19-9 > 200 U/ml is virtually diagnostic of pancreatic malignancy. In similar patients with CA19-9 > 300 U/ml, resection is rarely possible and tumors are advanced.
Department of Medicine, University of Florida, Gainesville.
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CE
Forsmark
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Lambiase
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SB
Vogel
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018395:CA-19-9 Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies
D018395:CA-19-9 Antigen