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Serum tumor markers not useful in screening patients with pancreatic mucinous cystic lesions associated with malignant changes |
Raffaele Pezzilli, Lucia Calculli, Gianvico Melzi d’Eril and Alessandra Barassi |
Bologna, Italy
Author Affiliations: Department of Digestive System (Pezzilli R) and Department of Radiology (Calculli L), Sant’Orsola-Malpighi Hospital, Via Massarenti 9, Bologna 40138, Italy; Department of Health Sciences, San Paolo Hospital, University of Milan, Milano 20100, Italy (Melzi d’Eril G and Barassi A)
Corresponding Author: Raffaele Pezzilli, MD, Dipartimento di Apparato Digerente, Ospedale Sant’Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy (Tel/Fax: +39-051-214-4148; Email: raffaele.pezzilli@aosp.bo.it) |
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Abstract BACKGROUND: Serum cancer antigen 19-9 (CA19-9) provides additional information about mucinous cystic pancreatic neoplasm (MPN). This study was undertaken to assess both CA19-9 and carcinoembryonic antigen (CEA) serum concentrations in consecutive patients affected by MPNs and other chronic benign and malignant pancreatic diseases. We also evaluated whether serum CA19-9 and CEA determinations provide additional information such as the presence of invasive carcinoma in MPN patients.
METHODS: Serum CA19-9 and CEA from 91 patients with pancreatic diseases were tested by commercially available kits at the time of diagnosis. The upper reference limit of serum CA19-9 was 37 U/mL and that of serum CEA was 3 ng/mL.
RESULTS: Thirty-five patients was diagnosed with chronic pancreatitis (CP), 32 with MPN, and 24 with pancreatic ductal adenocarcinoma (PDAC) confirmed histologically. Surgery was carried out in 5 CP patients, in 10 MPN patients (7 of them had severe dysplasia), and 9 PDAC patients. Serum CA19-9 activity was high in 12 (34.3%) CP patients, in 7 (21.9%) MPN patients, and in 12 (50.0%) PDAC patients (P=0.089). High serum CEA concentrations were noted in 6 (17.1%) CP patients, in 6 (18.8%) MPN patients, and in 12 (50.0%) PDAC patients (P=0.010). In the 7 MPN patients associated with histologically confirmed severe dysplasia, 3 (42.9%) patients had elevated serum activity of serum CA19-9, and 2 (28.6%) patients had high levels of CEA.
CONCLUSION: Serum determination of oncological markers is not useful in selecting MPN patients with malignant changes.
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