Serum CA 242: the search for a valid marker of pancreatic cancer

Many efforts have been made to find valuable serum tumour markers which help the diagnosis of pancreatic cancer. In the present study we investigated the diagnostic value of CA 242 in comparison with two other routinely used tumour markers (CA 19-9 and CA 50). Two-hundred and seventy six subjects were enrolled in this study: 46 patients with pancreatic cancer preoperatively, 53 with chronic pancreatitis, 28 with acute pancreatitis, 49 with other malignancies, 50 with miscellaneous non-neoplastic digestive diseases, and 50 healthy subjects. CA 242 was determined in serum by means of a two-step fluoroimmunometric assay. Sensitivities of CA 242, CA 19-9 and CA 50 for pancreatic cancer when all patients were considered were 41.3%, 54.3% and 47.8%, respectively (95% specificity level). No significant improvement was achieved by combination of CA 242 with CA 19-9 and/or CA 50. Cholestasis affected serum levels of CA 242 in patients without pancreatic cancer, but not in those with this tumour. The metastatic stage of pancreatic cancer appeared to influence the levels of CA 242. In conclusion, CA 242 serum assay does not seem to improve diagnostic accuracy for pancreatic cancer compared to CA 19-9 and CA 50.