title: A Panel of CA19-9, Ca125, and Ca15-3 as the Enhanced Test for the Differential Diagnosis of the Pancreatic Lesion.
abstract: Background. Proper diagnosis of pancreatic lesion etiology is a challenging clinical dilemma. Studies suggest that surgery for suspected pancreatic ductal adenocarcinoma (PDAC) reveals a benign lesion in 5% to 13% of cases. The aim of our study was to assess whether routinely used biomarkers such as CA19-9, Ca125, Ca15-3, and CEA, when combined, can potentially yield an accurate test predicting pancreatic lesion etiology.Methods. We retrospectively analyzed data of 326 patients who underwent a diagnostic process due to pancreatic lesions of unknown etiology.Results. We found statistically significant differences in mean levels of all biomarkers. In logistic regression model, we applied levels CA19-9, Ca125, and Ca15-3 as variables. Two validation methods were used, namely, random data split into training and validation groups and bootstrapping. Afterward, we built ROC curve using the model that we had created, reaching AUC = 0,801. With an optimal cut-off point, it achieved specificity of 81,2% and sensitivity of 63,10%. Our proposed model has superior diagnostic accuracy to both CA19-9 (p= 0,0194) and CA125 (p= 0,0026).Conclusion. We propose a test that is superior to CA19-9 in a differential diagnosis of pancreatic lesion etiology. Although our test fails to reach exceptionally high accuracy, its feasibility and cost-effectiveness make it clinically useful.
authors.affiliation: Department of General and Transplant Surgery, Medical University of Lodz, 22 Kopcinskiego St., 90-153 Lodz, Poland.
authors.forename: Piotr
authors.identifier: 0000-0002-4458-0145
authors.initials: P
authors.lastname: Hogendorf
authors.affiliation: Department of General and Transplant Surgery, Medical University of Lodz, 22 Kopcinskiego St., 90-153 Lodz, Poland.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Skulimowski
authors.affiliation: Department of General and Transplant Surgery, Medical University of Lodz, 22 Kopcinskiego St., 90-153 Lodz, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Durczyński
authors.affiliation: Department of Pulmonology and Allergy, Medical University of Lodz, 22 Kopcinskiego St., 90-153 Lodz, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Kumor
authors.affiliation: Department of Anesthesiology and Intensive Care, Medical University of Lodz, 22 Kopcinskiego St., 90-153 Lodz, Poland.
authors.forename: Grażyna
authors.initials: G
authors.lastname: Poznańska
authors.affiliation: Department of General and Transplant Surgery, Medical University of Lodz, 22 Kopcinskiego St., 90-153 Lodz, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Oleśna
authors.affiliation: Department of General and Transplant Surgery, Medical University of Lodz, 22 Kopcinskiego St., 90-153 Lodz, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Rut
authors.affiliation: Department of General and Transplant Surgery, Medical University of Lodz, 22 Kopcinskiego St., 90-153 Lodz, Poland.
authors.forename: Janusz
authors.identifier: 0000-0003-3438-9512
authors.initials: J
authors.lastname: Strzelczyk
mesh_terms: D000368:Aged; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood*; D012680:Sensitivity and Specificity
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate