MULTIVARIATE-ANALYSIS OF 6 SERUM TUMOR-MARKERS (CEA, CA-50, CA-242, TPA, TPS, TATI) AND CONVENTIONAL LABORATORY TESTS IN THE DIAGNOSIS OF HEPATOPANCREATOBILIARY MALIGNANCY

A prospective study of 277 patients with benign (n = 212) and malignan t (n = 65)) hepatopancreatobiliary disease was carried out to evaluate the value of six serum tumour markers (CEA, CA 50, CA 242 TPA, TPS, T ATI) and 16 conventional laboratory tests in the distinction between b enign and malignant diseases. In univariate analysis, all tumour marke r tests except TATI showed significantly (p < 0.001) higher serum valu es in the patients with malignant disease than in the patients with be nign disease. Among the conventional laboratory tests serum bilirubin, alkaline phosphatase and leucine aminopeptidase showed significantly (p < 0.001) higher values in the patients with malignant disease, wher eas serum protein and amylase levels were significantly (p < 0.01) hig her values in the patients with benign disease. In a multivariate anal ysis, serum bilirubin (p < 0.001), antithrombin III (p < 0.01) and blo od hemoglobin (p < 0.05) were the most significant independent predict ors of hepatopancreatobiliary malignancy. To sum rip the contributions of the best tests a diagnostic score (DS) was developed The sensitivi ty of DS in detecting malignancy was 73% with a specificity of 82% and an efficiency of 79%. In conclusion, our results speak against the us e of multiple tumor marker tests, and rather suggest the rise of a rel atively limited amount of conventional laboratory tests in the distinc tion between benign and malignant hepatopancreatobiliary disease.