CA 125, CA 19-9 AND CEA IN THE DIAGNOSIS OF PANCREATIC AND BILIARY CARCINOMA

Abstract

The values of serum tumor markers CEA, CA 19-9 and CA 125 alone and in combinations in the diagnosis of pancreatic and biliary carcinoma were investigated In this prospective study. Insufficiency in the diagnosis of pancreaticobiliary carcinoma still exists although much progress has been reached in imaging and biopsy technics. The number of investigations related to the diagnostic importance of CA 125 in pancreatic carcinoma and tumor markers in biliary carcinoma is less. The pretreatment serum levels of CEA (cut off value 5ng/mL), CA 19-9 (cut off value 37 U/mL) and CA 125(cut off value 35 U/mL ) in 77 patients with pancreaticobiliary carcinoma and in 140 patients with benign pancreaticobiliary disease were measured. The sensitivity of CEA, CA 19-9 and CA 125 were42.8%, 76.8% and 66%. 1 and specificity were 83.9%, 74.2% and 64.5% respectively for pancreatic carcinoma. There was no significant difference between the positiveness rates of CA 19-9 and CA125 in subgroups of with and without obstructive jaundice. On the other hand, in benign pancreatic disease CA 19-9 in subgroup with jaundice and CA 125 in cases without jaundice were significantly high. The sensitivity of CEA, CA 19-9 and CA 125 were 19%, 85.7% and 52.4% and specificity were 93.6%, 67,9% and 79.8% respectively for biliary carcinoma. The positiveness of CA 19-9 in benign biliary disease were significantly higher in subgroup with jaundice than the others without jaundice, where as the positiveness of CA 125 was not different in these two subgroups. Marker combinations had not significantly diagnostic value as compared to markers used alone. In conclusion, in the differential diagnosis of pancreatic carcinoma CA 19-9 in cases without jaundice and CA 125 in cases with jaundice may be beneficial. In the diagnosis of biliary carcinoma CA 125 has a limited value.