Islet amyloid polypeptide is not a satisfactory marker for detecting pancreatic cancer

Background & Aims: Islet amyloid polypeptide (IAPP) levels are elevated in pancreatic cancer and may be a useful marker of pancreatic cancer-associate d diabetes. The aim of this study was to compare the sensitivity and specif icity for pancreatic cancer of IAPP with that of CA19-9, examine clinical c haracteristics of diabetes in pancreatic cancer, and define the relationshi p of IAPP to diabetes of pancreatic cancer. Methods: Fasting serum glucose, IAPP, and CA :19-9 were measured in :130 subjects with pancreatic cancer, 250 subjects with other pancreatic and peripancreatic diseases, and 116 con trols. In pancreatic cancer patients, we noted tumor stage and the presence and duration of diabetes. Results; IAPP was markedly elevated in pancreati c cancer, especially in patients with diabetes. However, the sensitivity of IAPP for pancreatic cancer was less than that of CA:19-9 (40% vs. 75%; P < 0.001). Diabetes was present in 46% of pancreatic cancers and 55% of resec table tumors. In pancreatic cancer with diabetes, the sensitivity of IAPP w as only 50%. In resectable cancer it was 27%. Conclusions: IAPP is elevated in pancreatic cancer but is not sensitive enough to replace or complement existing tests. Diabetes occurs early and frequently in pancreatic cancer. Development of a sensitive and specific marker for pancreatic-associated di abetes might lead to diagnosis of resectable pancreatic cancer.