Pancreatic Adenocarcinoma - CA-19-9 Marker

3/13/02 (Merchant)

Question: What is the sensitivity/specificity of CA-19-9 in the diagnosis of pancreatic adenocarcinoma?

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Unique Identifier:11490844

Authors: Ichihara T. Nomoto S. Takeda S. Nagura H. Sakamoto J. Kondo K. Horisawa M. Nakao A.

Institution: Department of Surgery, Nagoya National Hospital, 4-1-1 San-no-maru, Naka-ku, Nagoya, Aichi 460-0001, Japan.

Title: Clinical usefulness of the immunostaining of the tumor markers in pancreatic cancer. [Review] [36 refs]

Source: Hepato-Gastroenterology. 48(40):939-43, 2001 Jul-Aug.

Abstract: The effect of the rapid immunostaining of gastrointestinal cancer-associated antigens, CA19-9, CEA, DUPAN2, and CA50 was discussed for intraoperative pathological diagnosis of pancreatic cancer. The method can be completed in only 13 minutes with microwave irradiation to accelerate the incubation of the primary antibody. Only 3 seconds of irradiation at 500 W for fresh-frozen sections produced specific antigen staining of greater intensity than that obtained with longer incubation by the conventional method. Preservation of the tissue structure was satisfactory with minimal nonspecific background staining enabling us to diagnose the intrapancreatic spread of cancer. This method was also applied to intraoperative peritoneal washing cytology. As with frozen section biopsy, the sensitivity of intraoperative cytology is greater than by the conventional staining method, which is able to achieve more precise staging of pancreatic cancers. Our rapid immunoperoxidase staining method on the cryostat section of pancreatic biopsy specimens and on cytology samples provides important information to determine an appropriate operative approach for pancreatic cancer. [References: 36] CAS Registry/EC Number 0 (CA-19-9 Antigen). 0 (Carcinoembryonic Antigen).

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Unique Identifier:11149048

Authors: Nazli O. Bozdag AD. Tansug T. Kir R. Kaymak E.

Institution: Ataturk Training Hospital 3. Surgical Clinic Izmir, Turkey. bozdag@egenet.com.tr

Title: The diagnostic importance of CEA and CA 19-9 for the early diagnosis of pancreatic carcinoma.

Source: Hepato-Gastroenterology. 47(36):1750-2, 2000 Nov-Dec.

Abstract: BACKGROUND/AIMS: CA 19-9 and CEA were evaluated for their specificity and sensitivity in the early diagnosis of pancreatic carcinoma. METHODOLOGY: This prospective study included 40 patients with pancreatic carcinoma. A control group of 60 patients were divided into two subgroups as upper gastrointestinal system malignancies and benign pancreatic disorders. CEA and CA 19-9 levels were measured in all the patients. RESULTS: When the reference value of CA 19-9 was accepted as 74 U/mL, the specificity was 100% when pancreatic carcinoma was compared with benign disorders of the pancreas, but it's specificity for upper gastrointestinal malignancies was 60-90%. When the reference value of CEA was increased, the sensitivity had been decreased but the specificity had been increased when compared with the control group. If the reference value of CEA was accepted as 5 ng/mL, the specificity was 100% when pancreatic carcinoma was compared with acute or chronic pancreatitis, but it is less specific for the differential diagnosis of pancreatic carcinoma from the upper gastrointestinal malignancies. CONCLUSIONS: With the progression of the pancreatic carcinoma, serum CEA level and the specificity of CEA were elevated similar to that of CA 19-9. However, the elevation of CEA specificity when compared with the control group was lower than the specificity of the CA 19-9 and the sensitivity of CA 19-9 was superior to that of CEA for pancreatic carcinoma. The level of CA 19-9 was increased with the development of early pancreatic cancer and this elevation steadily continued with the progression of the cancer. CAS Registry/EC Number 0 (CA-19-9 Antigen). 0 (Carcinoembryonic Antigen).

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Unique Identifier:10897004

Authors: Slesak B. Harlozinska-Szmyrka A. Knast W. Sedlaczek P. van Dalen A. Einarsson R.

Institution: Department of Tumor Immunology, Wroclaw Medical University, Wroclaw, Poland.

Title: Tissue polypeptide specific antigen (TPS), a marker for differentiation between pancreatic carcinoma and chronic pancreatitis. A comparative study with CA 19-9.

Source: Cancer. 89(1):83-8, 2000 Jul 1.

Abstract: BACKGROUND: The value of serum tissue polypeptide specific antigen (TPS) as a complement to CA 19-9 in the detection of pancreatic carcinoma was determined prospectively. TPS and CA 19-9 levels obtained at the time of diagnosis in patients suspected of having chronic pancreatitis or pancreatic carcinoma were evaluated in receiver operating characteristic (ROC) curve analysis. METHODS: Serum TPS and CA 19-9 levels were measured by immunoassays in 122 subjects, 48 with pancreatic carcinoma and 74 with chronic pancreatitis. RESULTS: Elevated levels of CA 19-9 were detected preoperatively in 70% of pancreatic carcinoma patients and in 19% of chronic pancreatitis patients. Elevated levels of TPS were detected in 100% of patients with pancreatic carcinoma and in 22% of patients with chronic pancreatitis. The median levels of TPS and CA 19-9 for pancreatic carcinoma were significantly higher than those for chronic pancreatitis (P < 0.0001). Increasing the upper reference value of TPS allowed for better discrimination between chronic pancreatitis and pancreatic carcinoma. ROC curve analysis showed that the introduction of 200 U/L as a decision criterion for TPS did not reduce its sensitivity but significantly improved its specificity. At a specificity of 98% for TPS, discrimination between pancreatic carcinoma and chronic pancreatitis was found to be 97%. Increasing the upper reference level for CA 19-9 to attain a specificity of 98% decreased its sensitivity from 70% to 33%. CONCLUSIONS: At an elevated cut-off level for TPS (200 U/L), almost complete discrimination between pancreatic carcinoma and chronic pancreatitis was obtained. TPS will be more useful than CA 19-9 in the differential diagnosis of pancreatic carcinoma and chronic pancreatitis. Copyright 2000 American Cancer Society. CAS Registry/EC Number 0 (CA-19-9 Antigen). 0 (Tissue Polypeptide Antigen). 0 (Tumor Markers, Biological).

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Unique Identifier:8776607

Authors: Banfi G. Bravi S. Ardemagni A. Zerbi A.

Institution: Servizio Integrato di Medicina di Laboratorio, Istituto Scientifico H. S. Raffaele, Milano, Italy.

Title: CA 19.9, CA 242 and CEA in the diagnosis and follow-up of pancreatic cancer.

Source: International Journal of Biological Markers. 11(2):77-81, 1996 Apr-Jun.

Abstract: The diagnosis of pancreatic cancer is usually made in the advanced stages of the disease when the prognosis is poor. We compared the behavior of CA19.9, CEA and the newly proposed mucin CA242 in a consecutive series of 42 pancreatic carcinomas. A control group was recruited of 21 patients with benign pancreatic diseases. With the recommended cutoffs (37 U/ml for CA19.9, 20 U/ml for CA242 and 8 ng/ml for CEA) we obtained a specificity of 90% for CA19.9 and of 85% for CA242 and CEA. The sensitivity was 85.7% for CA19.9, 73.8% for CA242 and 26.2% for CEA. CA19.9 and CA242 showed identical behavior in various TNM stages of cancer and in stages III and IV of the Hermreck classification. Moreover, CA19.9 and CA242 showed identical behavior in 10 patients monitored during the survival period who developed recurrence of disease. ROC curve evaluation demonstrated that CA242 and CA19.9 were very similar. The results of CA242 were better than those of CA19.9 in the false positive range under 10%, whereas CA19.9 had a better performance in the true positive range over 70%. CA242 could be used instead of CA19.9 for diagnosing pancreatic carcinoma. CAS Registry/EC Number 0 (Antigens, Tumor-Associated, Carbohydrate). 0 (CA 242 antigen). 0 (CA-19-9 Antigen). 0 (Carcinoembryonic Antigen).