title: Serum tumor markers not useful in screening patients with pancreatic mucinous cystic lesions associated with malignant changes.
abstract: BACKGROUND
  Serum cancer antigen 19-9 (CA19-9) provides additional information about mucinous cystic pancreatic neoplasm (MPN). This study was undertaken to assess both CA19-9 and carcinoembryonic antigen (CEA) serum concentrations in consecutive patients affected by MPNs and other chronic benign and malignant pancreatic diseases. We also evaluated whether serum CA19-9 and CEA determinations provide additional information such as the presence of invasive carcinoma in MPN patients.
  
  
  METHODS
  Serum CA19-9 and CEA from 91 patients with pancreatic diseases were tested by commercially available kits at the time of diagnosis. The upper reference limit of serum CA19-9 was 37 U/mL and that of serum CEA was 3 ng/mL.
  
  
  RESULTS
  Thirty-five patients was diagnosed with chronic pancreatitis (CP), 32 with MPN, and 24 with pancreatic ductal adenocarcinoma (PDAC) confirmed histologically. Surgery was carried out in 5 CP patients, in 10 MPN patients (7 of them had severe dysplasia), and in 9 PDAC patients. Serum CA19-9 activity was high in 12 (34.3%) CP patients, in 7 (21.9%) MPN patients, and in 12 (50.0%) PDAC patients (P=0.089). High serum CEA concentrations were noted in 6 (17.1%) CP patients, in 6 (18.8%) MPN patients, and in 12 (50.0%) PDAC patients (P=0.010). In the 7 MPN patients associated with histologically confirmed severe dysplasia, 3 (42.9%) patients had elevated serum activity of serum CA19-9, and 2 (28.6%) patients had high levels of CEA.
  
  
  CONCLUSIONS
  Serum determination of oncological markers is not useful in selecting MPN patients with malignant changes.
authors.affiliation: Department of Digestive System, Sant'Orsola-Malpighi Hospital, Via Massarenti 9, Bologna 40138, Italy. raffaele.pezzilli@aosp.bo.it.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pezzilli
authors.forename: Lucia
authors.initials: L
authors.lastname: Calculli
authors.forename: Gianvico
authors.initials: G
authors.lastname: Melzi d'Eril
authors.forename: Alessandra
authors.initials: A
authors.lastname: Barassi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D011933:Reagent Kits, Diagnostic; D015203:Reproducibility of Results; D015854:Up-Regulation
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D011933:Reagent Kits, Diagnostic