title: Carbohydrate antigen 19-9 for differential diagnosis of pancreatic carcinoma and chronic pancreatitis.
abstract: OBJECTIVE
  To evaluate the utility of carbohydrate antigen 19-9 (CA19-9) for differential diagnosis of pancreatic carcinoma and chronic pancreatitis.
  
  
  METHODS
  We searched the literature for studies reporting the sensitivity, specificity, and other accuracy measures of serum CA19-9 levels for differentiating pancreatic carcinoma and chronic pancreatitis. Pooled analysis was performed using random-effects models, and receiver operating characteristic (ROC) curves were generated. Study quality was assessed using Standards for Reporting Diagnostic Accuracy and Quality Assessment for Studies of Diagnostic Accuracy tools.
  
  
  RESULTS
  A total of 34 studies involving 3125 patients with pancreatic carcinoma and 2061 patients with chronic pancreatitis were included. Pooled analysis of the ability of CA19-9 level to differentiate pancreatic carcinoma and chronic pancreatitis showed the following effect estimates: sensitivity, 0.81 (95%CI: 0.80-0.83); specificity, 0.81 (95%CI: 0.79-0.82); positive likelihood ratio, 4.08 (95%CI: 3.39-4.91); negative likelihood ratio, 0.24 (95%CI: 0.21-0.28); and diagnostic odds ratio, 19.31 (95%CI: 14.40-25.90). The area under the ROC curve was 0.88. No significant publication bias was detected.
  
  
  CONCLUSIONS
  Elevated CA19-9 by itself is insufficient for differentiating pancreatic carcinoma and chronic pancreatitis, however, it increases suspicion of pancreatic carcinoma and may complement other clinical findings to improve diagnostic accuracy.
authors.affiliation: Si-Biao Su, Shan-Yu Qin, Wei Luo, Hai-Xing Jiang, Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
authors.forename: Si-Biao
authors.initials: SB
authors.lastname: Su
authors.affiliation: Si-Biao Su, Shan-Yu Qin, Wei Luo, Hai-Xing Jiang, Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
authors.forename: Shan-Yu
authors.initials: SY
authors.lastname: Qin
authors.affiliation: Si-Biao Su, Shan-Yu Qin, Wei Luo, Hai-Xing Jiang, Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Chen
authors.affiliation: Si-Biao Su, Shan-Yu Qin, Wei Luo, Hai-Xing Jiang, Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Luo
authors.affiliation: Si-Biao Su, Shan-Yu Qin, Wei Luo, Hai-Xing Jiang, Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
authors.forename: Hai-Xing
authors.initials: HX
authors.lastname: Jiang
mesh_terms: D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D002277:Carcinoma / Q000097:blood* / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D016017:Odds Ratio; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000175:diagnosis; D050500:Pancreatitis, Chronic / Q000097:blood* / Q000175:diagnosis; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D015854:Up-Regulation
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen
keywords: Carbohydrate antigen; Chronic pancreatitis; Diagnosis; Meta-analysis; Pancreatic carcinoma