Evaluation of a Serologic Marker, CA19-9, in the Diagnosis of Pancreatic Cancer
Authors: Douglas K. Pleskow, Harvey J. Berger, John Gyves, Elaine Allen, Arlene McLean, Daniel K. Podolsky
Journal: Annals of Internal Medicine (1989)

Article1 May 1989Evaluation of a Serologic Marker, CA19-9, in the Diagnosis of Pancreatic CancerDouglas K. Pleskow, MD, Harvey J. Berger, MD, John Gyves, MD, Elaine Allen, PhD, Arlene McLean, PhD, Daniel K. Podolsky, MDDouglas K. Pleskow, MDSearch for more papers by this author, Harvey J. Berger, MDSearch for more papers by this author, John Gyves, MDSearch for more papers by this author, Elaine Allen, PhDSearch for more papers by this author, Arlene McLean, PhDSearch for more papers by this author, Daniel K. Podolsky, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-110-9-704 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptStudy Objective: To determine the utility of the serologic marker CA19-9 in the diagnosis of pancreatic cancer in patients suspected of having a pancreatic disorder.Design: Blinded study of frozen pedigreed serum samples collected at time of diagnostic evaluation with follow-up review at a mean of 8 years.Setting: A general university teaching hospital serving both primary and referral patient populations.Measurements and Main Results: Sera collected prospectively from 1978 to 1980 from 261 patients undergoing imaging studies of the pancreas (ultrasound, computed tomography, endoscopic retrograde cholangiopancreatography) for a variety of symptoms were assayed for CA19-9 levels, and the results were compared with earlier determinations of other potential markers for pancreatic cancer. In 54 patients ultimately shown to have pancreatic cancer, the CA19-9 assay showed a sensitivity of 70% with a median value of 349 u/mL (normal < 70 u/mL) and range, 7.3 to 2 859 964 u/mL, whereas specificity of the marker in this population was 87%. The positive predictive value was 59%, and the negative predictive value was 92%. Results of CA19-9 testing in the small group of patients with definitive staging information showed no difference in sensitivity between patients with local/regional disease (n = 6) and those with distant metastases (n = 14), 50% compared with 71% (P= 0.613).Conclusion:CA19-9 was found to be a more sensitive and specific marker of pancreatic cancer than other serologic markers and should be a useful test in the patient with suspected pancreatic disease. Annals of Internal Medicine. 1989;110:704-709....References1. MooreKupchikMarconZamcheck THNN. Carcinoembryonic antigen assay in cancer of the colon and pancreas and other digestive tract disorders. 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Nardone, MDThe Eutherian Fetoembryonic Defense System Hypothesis: An UpdateDiagnosis and Evaluation of Pancreatic Ductal Adenocarcinoma 1 May 1989Volume 110, Issue 9Page: 704-709KeywordsEndoscopic retrograde cholangiopancreatographyNegative predictive valuePancreasPancreatic cancerPancreatic diseasesPatientsPopulation statisticsPositive predictive valueSpecificityUltrasound imaging Issue Published: 1 May 1989 Copyright©1989 American College of PhysiciansPDF DownloadLoading ...