Diagnostic importance of the tumor marker CA 19-9 in pancreatic cancer

The diagnostic value of the tumour-associated antigen CA 19-9 was tested in 309 patients, 156 with malignancies (39 carcinoma of the pancreas, 117 extrapancreatic malignant tumour) and 153 patients with non-malignant disease (54 chronic pancreatitis, 25 acute pancreatitis, 74 general surgical disease). Levels above the normal range of 6-37 U/ml were obtained in 95% of patients with carcinoma of the pancreas (mean value 528 U/ml), in 31% of patients with gastric carcinoma and 16% with colorectal carcinoma (mean 8 U/ml). Results of the pre-operative determination of CA 19-9 indicated for carcinoma of the pancreas a sensitivity of 95%, a specificity of 87% and an overall accuracy of 88%. Pre-operatively elevated CA 19-9 concentrations in patients with carcinoma of the pancreas fell to normal after curative resection of the neoplasm. After palliative operation or in inoperable carcinoma CA 19-9 serum concentrations were never less than 37 U/ml.