CA 19-9 to differentiate benign and malignant masses in chronic pancreatitis: is there any benefit.
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Date
2009-01
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Abstract
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 infl ammatory 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, specifi city 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 specifi city.
Results There were 50 benign masses and 34 malignancies.
The overall sensitivity and specifi city 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% specifi c 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.
Description
Keywords
Chronic pancreatitis, Carbohydrate antigen, Infl ammatory head masses
Citation
Bedi M M S, Gandhi M D, Jacob G, Lekha V, Venugopal A, Ramesh H. CA 19-9 to differentiate benign and malignant masses in chronic pancreatitis: is there any benefit. Indian Journal of Gastroenterology. 2009 Jan-Feb; 28(1): 24-27.