Cancer antigens 19-9 and 125 in the differential diagnosis of pancreatic mass lesions.

HYPOTHESIS Accurate differentiation between inflammatory and neoplastic tumors of the pancreas remains a diagnostic dilemma for surgeons. The aim of the study was to assess the utility of 2 neoplastic markers, cancer antigen (CA) 19-9 and CA 125, in the differential diagnosis of pancreatic tumors. DESIGN The patients were assigned to a malignant or benign group based on cytological and histological evaluation of pancreatic lesion samples. The serum from each patient was tested for CA 19-9 and CA 125. SETTING AND PATIENTS One hundred ten patients with heterogeneous pancreatic lesions (inflammatory and malignant tumors) treated at a surgical department of a university hospital were analyzed. INTERVENTIONS Samples for cytological and histological evaluation were taken during ultrasonography-guided fine-needle aspiration biopsy or open surgery. MAIN OUTCOME MEASURES Sensitivity, specificity, and positive and negative predictive values of each test in the differential diagnosis of pancreatic tumors were determined. RESULTS The sensitivity, specificity, positive predictive value, and negative predictive value of the CA 19-9 test were 80.8%, 89.1%, 93.7%, and 89.2%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of the CA 125 test were 60.8%, 83.3%, 88.2%, and 50.8%, respectively. The sensitivity and specificity of a combined evaluation of both CA 19-9 and CA 125 tests were 87.8% and 77.8%, respectively. CONCLUSIONS Taking into account the high but still limited sensitivity and specificity of the CA 19-9 and CA 125 tests, their results in the differential diagnosis of pancreatic tumors should be interpreted consistently and in reference to imaging techniques such as ultrasonography and computed tomography.