Diagnostic utility of clinical and biochemical parameters in pancreatic head malignancy patients with normal carbohydrate antigen 19-9 levels.
BACKGROUND
Carbohydrate antigen (CA)19-9 that is the most widely used biomarker for pancreatic cancer has certain limitations in diagnosis, which results in a tough job to distinguish pancreatic cancer from benign tumors with normal CA19-9. The aim of this study was to investigate the diagnostic utility of clinical parameters and serum markers in patients with pancreatic head masses but without elevated CA19-9.


METHODS
Retrospectively, 106 (69 malignant, 37 benign) of 487 patients admitted for pancreatic head masses were enrolled with CA19-9 level of <37u/ml. Clinical parameters and serum biomarkers were assessed. Among the patients with pancreatic head mass, male individuals (p=0.025) and elder individuals (p<0.001) were more likely to have cancer; and cancer patients were more likely to present with abdominal-pain (p=0.023), weight-loss (p=0.013) and jaundice (p<0.001). Serum bilirubin levels among malignancies, including total bilirubin (p<0.001), direct bilirubin (p<0.001) and indirect bilirubin (p<0.001), were considerably higher than those of benign ones. Logistic regression further concluded that age-distribution, abdominal-pain and direct-bilirubin were three independent factors correlating with final diagnosis. However, CEA (p=0.156) was not sufficient enough to exclude pancreatic cancer.


CONCLUSIONS
In patients with pancreatic head masses and CA19-9 of <37u/ml, age-distribution, abdominal-pain and direct bilirubin might be helpful in differential diagnosis. CEA was insufficient for exclusion of malignancy.
['Jin|Xiaoli|X|', 'Wu|Yulian|Y|']
D015746:Abdominal Pain D000328:Adult D000368:Aged D015295:Antigens, Tumor-Associated, Carbohydrate D001663:Bilirubin D014408:Biomarkers, Tumor D018395:CA-19-9 Antigen D005260:Female D006801:Humans D007565:Jaundice D016015:Logistic Models D008297:Male D008875:Middle Aged D010190:Pancreatic Neoplasms D011237:Predictive Value of Tests D012189:Retrospective Studies D012680:Sensitivity and Specificity
pancreatic head malignancy biomarker diagnosis clinical parameter