TUMOR-MARKER CA 50 LEVELS COMPARED TO SIGNS AND SYMPTOMS IN THE DIAGNOSIS OF PANCREATIC-CANCER

The diagnostic merits of CA 50 and of symptoms indicating pancreatic c ancer (pain, jaundice, weight loss, malabsorption) were compared prosp ectively in 512 consecutive patients. Among the final diagnoses were: exocrine pancreatic cancer, 175; periampullary cancer, 44; other gastr ointestinal cancer, 45; and chronic pancreatitis, 64 cases. The suspec ted diagnoses based on symptoms and signs were correct in 80% of the p atients with exocrine pancreatic cancer, in 78% with periampullary, in 76% with other gastrointestinal cancer and in 90% with chronic pancre atitis. CA 50 was pathological in 96% of the cases with exocrine pancr eatic cancer, in 70% with periampullary, in 78% with other gastrointes tinal malignancies and in 36% with chronic pancreatitis. The sensitivi ty was 96%, specificity 48%, positive prediction 49% and negative pred iction 96%, depending on cut-off level. The single CA 50 value was com parable to symptoms and signs regarding sensitivity and negative predi ction. In 28 of 42 cases incorrectly clinically classified, CA 50 alon e indicated a benign or malignant diagnosis. If both the modalities 's igns and symptoms' and CA 50 were combined, the sensitivity was 91%, t he specificity 92%, the positive prediction 86% and the negative predi ction 95%. The initial CA 50 value can help to indicate in which patie nts a pancreatic malignancy should be suspected.