The value of standard serum tumor markers in differentiating mucinous from serous cystic tumors of the pancreas

CEA, Ca 19-9, Ca 125, Ca 15-3

Claudio Bassi, Roberto Salvia, Andrew A. Gumbs, Giovanni Butturini, Massimo Falconi, Paolo Pederzoli

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Background: Differentiating between mucinous cystic tumors (MCTs) and serous cystic tumors (SCTs) can be a troubling diagnostic dilemma in pancreatology: when SCTs present in their macro-oligocystic form they must be resected because MCT cannot be ruled out, and some tumors considered benign are actually MCTs, which delays diagnosis and places patients at increased risk. Examination of preoperative serum tumor markers may help improve preoperative diagnosis. Materials and methods: The tumor markers CEA, Ca 19-9, Ca 125, and Ca 15-3 were examined in 157 patients with SCTs or MCTs. Results: Positive CEA marker status is an indicator of an MCT, although sensitivity is low at 17%. Using three serum tumor markers (CEA, Ca 19-9, and Ca 125), 27% of MCTs were found to have two or more markers positive, compared to none for the SCTs. Sensitivity decreases to 13% for differentiating benign MCTs from benign SCTs but specificity remains 100%. Conclusions: In the differential diagnosis of SCTs vs. MCTs no reliable serum tumor marker exists which can diagnose SCTs and spare some patients unnecessary operations. Nonetheless, positive CEA serum marker status and or the presence of more than two positive serum markers (CEA, Ca 19-9, or Ca 125) indicates the presence of an MCT and can prevent delay in diagnosis.

Original languageEnglish
Pages (from-to)281-285
Number of pages5
JournalLangenbeck's Archives of Surgery
Volume387
Issue number7-8
DOIs
Publication statusPublished - 2002

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Tumor Biomarkers
Pancreas
Biomarkers
Neoplasms

Keywords

  • Cystic tumors
  • Differential diagnosis
  • Pancreatology
  • Serum tumor markers

ASJC Scopus subject areas

  • Surgery

Cite this

The value of standard serum tumor markers in differentiating mucinous from serous cystic tumors of the pancreas : CEA, Ca 19-9, Ca 125, Ca 15-3. / Bassi, Claudio; Salvia, Roberto; Gumbs, Andrew A.; Butturini, Giovanni; Falconi, Massimo; Pederzoli, Paolo.

In: Langenbeck's Archives of Surgery, Vol. 387, No. 7-8, 2002, p. 281-285.

Research output: Contribution to journalArticle

Bassi, Claudio ; Salvia, Roberto ; Gumbs, Andrew A. ; Butturini, Giovanni ; Falconi, Massimo ; Pederzoli, Paolo. / The value of standard serum tumor markers in differentiating mucinous from serous cystic tumors of the pancreas : CEA, Ca 19-9, Ca 125, Ca 15-3. In: Langenbeck's Archives of Surgery. 2002 ; Vol. 387, No. 7-8. pp. 281-285.
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abstract = "Background: Differentiating between mucinous cystic tumors (MCTs) and serous cystic tumors (SCTs) can be a troubling diagnostic dilemma in pancreatology: when SCTs present in their macro-oligocystic form they must be resected because MCT cannot be ruled out, and some tumors considered benign are actually MCTs, which delays diagnosis and places patients at increased risk. Examination of preoperative serum tumor markers may help improve preoperative diagnosis. Materials and methods: The tumor markers CEA, Ca 19-9, Ca 125, and Ca 15-3 were examined in 157 patients with SCTs or MCTs. Results: Positive CEA marker status is an indicator of an MCT, although sensitivity is low at 17{\%}. Using three serum tumor markers (CEA, Ca 19-9, and Ca 125), 27{\%} of MCTs were found to have two or more markers positive, compared to none for the SCTs. Sensitivity decreases to 13{\%} for differentiating benign MCTs from benign SCTs but specificity remains 100{\%}. Conclusions: In the differential diagnosis of SCTs vs. MCTs no reliable serum tumor marker exists which can diagnose SCTs and spare some patients unnecessary operations. Nonetheless, positive CEA serum marker status and or the presence of more than two positive serum markers (CEA, Ca 19-9, or Ca 125) indicates the presence of an MCT and can prevent delay in diagnosis.",
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AU - Butturini, Giovanni

AU - Falconi, Massimo

AU - Pederzoli, Paolo

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N2 - Background: Differentiating between mucinous cystic tumors (MCTs) and serous cystic tumors (SCTs) can be a troubling diagnostic dilemma in pancreatology: when SCTs present in their macro-oligocystic form they must be resected because MCT cannot be ruled out, and some tumors considered benign are actually MCTs, which delays diagnosis and places patients at increased risk. Examination of preoperative serum tumor markers may help improve preoperative diagnosis. Materials and methods: The tumor markers CEA, Ca 19-9, Ca 125, and Ca 15-3 were examined in 157 patients with SCTs or MCTs. Results: Positive CEA marker status is an indicator of an MCT, although sensitivity is low at 17%. Using three serum tumor markers (CEA, Ca 19-9, and Ca 125), 27% of MCTs were found to have two or more markers positive, compared to none for the SCTs. Sensitivity decreases to 13% for differentiating benign MCTs from benign SCTs but specificity remains 100%. Conclusions: In the differential diagnosis of SCTs vs. MCTs no reliable serum tumor marker exists which can diagnose SCTs and spare some patients unnecessary operations. Nonetheless, positive CEA serum marker status and or the presence of more than two positive serum markers (CEA, Ca 19-9, or Ca 125) indicates the presence of an MCT and can prevent delay in diagnosis.

AB - Background: Differentiating between mucinous cystic tumors (MCTs) and serous cystic tumors (SCTs) can be a troubling diagnostic dilemma in pancreatology: when SCTs present in their macro-oligocystic form they must be resected because MCT cannot be ruled out, and some tumors considered benign are actually MCTs, which delays diagnosis and places patients at increased risk. Examination of preoperative serum tumor markers may help improve preoperative diagnosis. Materials and methods: The tumor markers CEA, Ca 19-9, Ca 125, and Ca 15-3 were examined in 157 patients with SCTs or MCTs. Results: Positive CEA marker status is an indicator of an MCT, although sensitivity is low at 17%. Using three serum tumor markers (CEA, Ca 19-9, and Ca 125), 27% of MCTs were found to have two or more markers positive, compared to none for the SCTs. Sensitivity decreases to 13% for differentiating benign MCTs from benign SCTs but specificity remains 100%. Conclusions: In the differential diagnosis of SCTs vs. MCTs no reliable serum tumor marker exists which can diagnose SCTs and spare some patients unnecessary operations. Nonetheless, positive CEA serum marker status and or the presence of more than two positive serum markers (CEA, Ca 19-9, or Ca 125) indicates the presence of an MCT and can prevent delay in diagnosis.

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