Evaluation of non-invasive diagnostic tests in detecting cancer of the pancreas

Monoclonal antibody defined antigen (CA19-9), carcinoembryonic antigen (CEA), ultrasonography (US) and computerized tomography (CT) were carried out as the tests in 113 patients suspected to have pancreatic cancer. Of 98 patients who underwent operation, 55 were found to have pancreatic cancer, 25 benign pancreatic disease, and 18 cancer of the biliary tract. Follow-up study was carried out for more than 1 year in 15 other patients suffering from pancreatitis without surgical intervention. The accuracy of CA19-9, US, CEA and CT was 87%, 69%, 61% and 56% respectively. The sensitivity of each test was CA19-9, 98%; US, 89%; CT, 80%; and CEA, 38%. The sensitivity of parallel test combined with CA19-9 and CEA was 100%. It may be regarded as the first step to detect pancreatic cancer in suspected population. The specificity of each test was CEA, 82%; CA19-9, 76%; US, 50% and CT, 40%. And the specificity of serial tests combined with CA19-9 and US was 90%. When these two tests were both positive, pancreatic cancer was highly suspected.