TPS, CA 19-9, VEGF-A, and CEA as Diagnostic and Prognostic Factors in
Patients with Mass Lesions in the Pancreatic Head

2008, Vol. 113, No. 1 , Pages 57-64
PDF (833 KB) PDF Plus (839 KB) ReprintsPermissionsGabriel Sandblom, Sofie Granroth and Ib Christian Rasmussen

Introduction: Although numerous tumour markers are available for periampullary tumours, including pancreatic cancer, their specificity and sensitivity have been questioned.

Materials and methods: To assess the diagnostic and prognostic values of tissue polypeptide specific antigen (TPS), carbohydrate antigen 19-9 (CA 19-9), vascular endothelial growth factor (VEGF-A), and carcinoembryonic antigen (CEA) we took serum samples in 56 patients with mass lesions in the pancreatic head. Among these patients, further investigations revealed pancreatic cancer in 20 patients, other malignant diseases in 12 and benign conditions in 24.

Results: Median CEA in all patients was 3.4 µg/L (range 0.5-585.0), median CA 19-9 was105 kU/L (range 0.6-1 300 00), median TPS 123.5 U/L (range 15.0-3350) and median VEGF-A 132.5 ng/L (range 60.0-4317). Area under the curve was 0.747, standard error (standard error [SE] =0.075) for CEA, 0.716 (SE=0.078) for CA 19-9 and 0.822 (SE=0.086) for TPS in ROC plots based on the ability of the tumours to distinguish between benign and malignant conditions. None of the markers significantly predicted survival in the subgroup of patients with pancreatic cancer.

Discussion: Our study shows that the markers may be used as fairly reliable diagnostic tools, but cannot be used to predict survival.