Cancer antigens 19-9 and 125 in the differential diagnosis of pancreatic mass lesions.

Abstract

HYPOTHESIS:

Accurate differentiation between inflammatory and neoplastic tumors of the pancreas remains a diagnostic dilemma for surgeons. The aim of the study was to assess the utility of 2 neoplastic markers, cancer antigen (CA) 19-9 and CA 125, in the differential diagnosis of pancreatic tumors.

DESIGN:

The patients were assigned to a malignant or benign group based on cytological and histological evaluation of pancreatic lesion samples. The serum from each patient was tested for CA 19-9 and CA 125.

SETTING AND PATIENTS:

One hundred ten patients with heterogeneous pancreatic lesions (inflammatory and malignant tumors) treated at a surgical department of a university hospital were analyzed.

INTERVENTIONS:

Samples for cytological and histological evaluation were taken during ultrasonography-guided fine-needle aspiration biopsy or open surgery.

MAIN OUTCOME MEASURES:

Sensitivity, specificity, and positive and negative predictive values of each test in the differential diagnosis of pancreatic tumors were determined.

RESULTS:

The sensitivity, specificity, positive predictive value, and negative predictive value of the CA 19-9 test were 80.8%, 89.1%, 93.7%, and 89.2%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of the CA 125 test were 60.8%, 83.3%, 88.2%, and 50.8%, respectively. The sensitivity and specificity of a combined evaluation of both CA 19-9 and CA 125 tests were 87.8% and 77.8%, respectively.

CONCLUSIONS:

Taking into account the high but still limited sensitivity and specificity of the CA 19-9 and CA 125 tests, their results in the differential diagnosis of pancreatic tumors should be interpreted consistently and in reference to imaging techniques such as ultrasonography and computed tomography.

• Authors: Grzegorz Cwik, Grzegorz Wallner, Tomasz Skoczylas, Aleksander Ciechanski, Krzysztof Zinkiewicz
• Journal: Archives of surgery (Chicago, Ill. : 1960) (Arch Surg) Vol. 141 Issue 10 Pg. 968-73; discussion 974 (Oct 2006) ISSN: 0004-0010 [Print] United States
• PMID: 17043274 (Publication Type: Journal Article)

Chemical References

• Biomarkers, Tumor
• CA-125 Antigen
• CA-19-9 Antigen

Topics

• Adult
• Aged
• Biomarkers, Tumor (blood)
• Biopsy, Fine-Needle
• CA-125 Antigen (blood)
• CA-19-9 Antigen (blood)
• Diagnosis, Differential
• Humans
• Male
• Middle Aged
• Pancreatic Neoplasms (blood, diagnosis, pathology)
• Sensitivity and Specificity