Improved diagnostic accuracy of pancreatic diseases with a combination of various novel serum biomarkers--case control study from Manipal Teaching Hospital, Pokhara, Nepal.
BACKGROUND
Pancreatic cancer is a distressing disease with a miserable prospects and early recognition remains a challenge due to ubiquitous symptomatic presentation, deep anatomical location, and aggressive etiology. False positives and problems in distinguishing pancreatitis from adenocarcinoma limit the use of CA 19-9 as both disorders can present with similar symptoms and share radiographic physiognomies. This study aimed to assess the relative increase in accuracy of diagnosing the patients with chronic pancreatitis, benign neoplasm of pancreas and adenocarcinomas with CA 19-9, haptoglobin, and serum amyloid A in comparison to CA 19-9 alone.


METHODS
This hospital based case control study was carried out in the Departments of Medicine and Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal, between 1st January 2010 and 31st December 2011. The variables assessed were age, gender, serum CA19-9, serum haptoglobulin, serum Amyloid A. The data were analyzed using Excel 2003, R 2.8.0 Statistical Package for the Social Sciences (SPSS) for Windows Version 16.0 (SPSS Inc; Chicago, IL, USA) and the EPI Info 3.5.1 Windows Version.


RESULTS
Out of 197 cases of pancreatic disease, maximum number of assumed cases were of adenocarcinoma of pancreas (95). Number of males (59) were more than females (36) in assumed cases of adenocarcinoma of pancreas. The mean values of CA19-9 raised considerably in cases of chronic pancreatitis, benign neoplasm and adenocarcinoma of pancreas when compared to controls. The highest augmention in CA19-9 values were in cases of adenocarcinoma of pancreas. The p-value indicates that in cases of chronic pancreatitis, there was not significant increase in precision of diagnosis.


CONCLUSIONS
These statistics established that haptoglobin and SAA are useful in discriminating cancer from benign conditions as well as healthy controls.
Department of Biochemistry, Manipal College of Medical Sciences, Pokhara, Nepal. drfrqms@aol.com
Mohammad Shamim
MS
Farooqui
Ankush
A
Mittal
Bibek
B
Poudel
Suhas Kumar
SK
Mall
Brijesh
B
Sathian
Mohammad
M
Tarique
Mohammad Hibban
MH
Farooqui
D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006242:Haptoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009390:Nepal; D010179:Pancreas / Q000378:metabolism; D010182:Pancreatic Diseases / Q000097:blood* / Q000175:diagnosis*; D011379:Prognosis; D000685:Serum Amyloid A Protein / Q000378:metabolism*
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; C485359:HP protein, human; D006242:Haptoglobins; D000685:Serum Amyloid A Protein