Serum CA19-9 in patients with solid pancreatic mass

This study evaluated the results and efficacy of serum CA 19-9 in determining the nature of a pancreatic solid mass in patients referred for investigation of possible malignancy.

A wide variety of tumor markers have been proposed for pancreatic cancer but currently the only one with any practical usefulness for diagnosis, prognosis, and monitoring of treatment is "CA 19-9".

This present study is a single center 2 year descriptive, prospective and case series studying patients with a pancreatic solid mass.

Serum CA 19-9 was checked in 159 patients. The majority of patients were male (68%) and 81% had mass in the head of pancreas. Pathologic assessment revealed 131 adenocarcinomas (82%), 10 other malignancies (6%), 7 benign lesion (4%) and was non-diagnostic in 11 cases (7%). Mean level of this tumor marker in patients with adenocarcinoma, non-adenocarcinoma malignancy, benign and non-diagnostic pathology was 1094, 1004, 120, 259 U/ML respectively. With regarding 58 U/ML as a cutoff point; sensitivity, specificity, positive predictive value, negative predictive value and accuracy of this tumor marker for diagnosing the adenocarcinoma were 85%, 67%, 88%, 60% and 81% respectively.

There was no significant relationship between Serum CA 19-9 value and histopathology of solid pancreatic mass. This marker has limited sensitivity and specificity and cannot be used as a definite diagnostic test. So the use of CA 19-9 for the differentiation of pancreatic cancer should be applied on an individual case basis, depending on the clinical situation and imaging findings.