CA 19-9 to differentiate benign and malignant masses in chronic pancreatitis: Is there any benefit?

被引：38

作者：

Bedi M.M.S. ^{[1
]}

Gandhi M.D. ^{[1
]}

Jacob G. ^{[1
]}

Lekha V. ^{[1
]}

Venugopal A. ^{[1
]}

Ramesh H. ^{[1
]}

机构：

[1] Digestive Diseases Center, Lakeshore Hospitals, Cochin - 682 304, Kerala

来源：

Indian Journal of Gastroenterology | 2009年 / 28卷 / 1期

关键词：

Carbohydrate antigen; Chronic pancreatitis; Inflammatory head masses;

D O I：

10.1007/s12664-009-0005-4

中图分类号：

学科分类号：

摘要：

Background: The role of the tumor marker CA 19-9 in differentiating benign from malignant masses in chronic pancreatitis has not been extensively studied. Aim: This study aims at assessing the accuracy of CA 19-9 in differentiating inflammatory head masses in chronic pancreatitis from superimposed carcinomas on chronic pancreatitis. Methods: The data of 84 consecutive patients who had mass lesions in chronic pancreatitis were analyzed to determine the sensitivity, specificity and predictive values at cut-off values of 37, 100, 200 and 300 U/mL. Receiver operating characteristic (ROC) curves were used to assess the sensitivity and specificity. Results: There were 50 benign masses and 34 malignancies. The overall sensitivity and specificity of CA 19-9 for cancer was 68% and 70%, respectively. There was a higher positivity of CA 19-9 in cancers than in benign masses (23/34; 68% versus 15/50; 30%, P<0.01) with cut-off values of 37 U/mL. Higher positivity rates were obtained in cancers using other cut-off values such as 100, 200 and 300 U/mL. Values over 300 U/mL were 100% specific for malignancy, but occurred in only 5 (of whom had distant metastases) of 34 patients. Conclusion: CA 19-9 level in excess of 300 U/mL in mass lesions in chronic pancreatitis was always indicative of malignancy. © Indian Society of Gastroenterology 2009.

引用

页码：24 / 27

页数：3

共 15 条

[1] Beger H.G., Schlosser W., Poch B., Gansague F., Inflammatory mass in the head of the pancreas, The Pancreas, 1, pp. 757-760, (1998)
[2] Ramesh H., Augustine P., Surgery in tropical pancreatitis: Analysis of risk factors, Br J Surg, 79, pp. 544-549, (1992)
[3] Boll D.T., Merkle E.M., Differentiating a chronic hyperplastic mass from pancreatic cancer: A challenge remaining in multidetector CT of the pancreas, European Radiology, 13, SUPPL. 5, (2003)
[4] Duffy M.J., CA 19-9 as a marker for gastrointestinal cancers: A review, Annals of Clinical Biochemistry, 35, 3, pp. 364-370, (1998)
[5] Safi F., Roscher R., Bittner R., Schenkluhn B., Dopfer H.P., Beger H.G., High sensitivity and specificity of CA 19-9 for pancreatic carcinoma in comparison to chronic pancreatitis. Serological and immunohistochemical findings, Pancreas, 2, pp. 398-403, (1987)
[6] Pulay I., Tihanyi T.F., Flautner L., Pancreatic head mass: What can be done? Classification: the clinical point of view, Journal of the Pancreas, 1, 3, pp. 85-90, (2000)
[7] Alexakis N., Halloran C., Raraty M., Ghaneh P., Sutton R., Neoptolemos J.P., Current standards of surgery for pancreatic cancer, British Journal of Surgery, 91, 11, pp. 1410-1427, (2004)
[8] Augustine P., Ramesh H., Is tropical pancreatitis premalignant?, Am J Gastroenterol, 87, pp. 1005-1008, (1992)
[9] Slesak B., Harlozinska-Szmyrka A., Knast W., Sedlaczek P., Van Dalen A., Einarsson R., Tissue polypeptide specific antigen (TPS), a marker for differentiation between pancreatic carcinoma and chronic pancreatitis. a comparative study with CA 19-9, Cancer, 89, pp. 83-88, (2000)
[10] Yiannakou J.Y., Newland P., Calder F., Kingsnorth A.N., Rhodes J.M., Prospective study of CAM 17.1/WGA mucin assay for serological diagnosis of pancreatic cancer, Lancet, 349, 9049, pp. 389-392, (1997)

← 1 2 →