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

Autor: Bedi MM; Digestive Diseases Center, Lakeshore Hospitals, Cochin, Kerala, India., Gandhi MD, Jacob G, Lekha V, Venugopal A, Ramesh H
Jazyk: angličtina
Zdroj: Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology [Indian J Gastroenterol] 2009 Jan-Feb; Vol. 28 (1), pp. 24-7. Date of Electronic Publication: 2009 Jun 06.
DOI: 10.1007/s12664-009-0005-4
Abstrakt: 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.
Databáze: MEDLINE
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