Serum tumor markers for pancreatic carcinoma

Various biochemical substances are being evaluated for use as serum tumor markers of adenocarcinoma of the pancreas. The currently established markers, CA 19-9 and POA, have an important but limited role in the diagnosis of pancreatic carcinoma. The role could be expanded if the specificity of these tests for pancreatic cancer could be increased, and this may be possible for each of these tests if several recent findings can be confirmed. Most of the new tumor markers are blood-group-related substances, in that the cancer-associated substances share epitopes that are similar to those of the Lewis blood group system. It seems likely that a "panel" of these markers could improve the specificity of these tests for pancreatic carcinoma. However, improvement of the clinical specificity appears unlikely since each of these markers has a high false-positive rate in patients with other cancers, liver diseases, and nonmalignant diseases of the pancreas. Additional study will be required to determine the optimal group of these tests to be used as a pancreatic cancer test panel. Also, more emphasis should be directed to the identification of tumor markers that can be used to detect pancreatic cancer at a stage when it can be treated effectively. The use of tumor markers for monitoring patients does not result in longer patient survival times or a higher survival rate because salvage therapies for this disease are ineffective. If effective salvage therapies can be developed, monitoring with serum tumor markers will become more significant. Thus, continued emphasis should be given to the development of serum tumor markers that have diagnostic utility.