title: Tumour marker CA 50 levels compared to signs and symptoms in the diagnosis of pancreatic cancer.
abstract: The diagnostic merits of CA 50 and of symptoms indicating pancreatic cancer (pain, jaundice, weight loss, malabsorption) were compared prospectively in 512 consecutive patients. Among the final diagnoses were: exocrine pancreatic cancer, 175; periampullary cancer, 44; other gastrointestinal cancer, 45; and chronic pancreatitis, 64 cases. The suspected diagnoses based on symptoms and signs were correct in 80% of the patients with exocrine pancreatic cancer, in 78% with periampullary, in 76% with other gastrointestinal cancer and in 90% with chronic pancreatitis. CA 50 was pathological in 96% of the cases with exocrine pancreatic cancer, in 70% with periampullary, in 78% with other gastrointestinal malignancies and in 36% with chronic pancreatitis. The sensitivity was 96%, specificity 48%, positive prediction 49% and negative prediction 96%, depending on cut-off level. The single CA 50 value was comparable to symptoms and signs regarding sensitivity and negative prediction. In 28 of 42 cases incorrectly clinically classified, CA 50 alone indicated a benign or malignant diagnosis. If both the modalities 'signs and symptoms' and CA 50 were combined, the sensitivity was 91%, the specificity 92%, the positive prediction 86% and the negative prediction 95%. The initial CA 50 value can help to indicate in which patients a pancreatic malignancy should be suspected.
authors.affiliation: Department of Surgery, University Hospital, Lund, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Pålsson
authors.forename: P
authors.initials: P
authors.lastname: Masson
authors.forename: A
authors.initials: A
authors.lastname: Andrén-Sandberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000473:pathology; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D002908:Chronic Disease; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis; D006801:Humans; D007565:Jaundice / Q000503:physiopathology; D008286:Malabsorption Syndromes / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000503:physiopathology; D010195:Pancreatitis / Q000175:diagnosis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D015431:Weight Loss
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; C082699:CA-50 antigen