Accuracy of simultaneous measurement of serum biomarkers: Carbohydrate antigen 19-9, pancreatic elastase-1, amylase, and lipase for diagnosing pancreatic ductal adenocarcinoma.


Journal

Journal of the Formosan Medical Association = Taiwan yi zhi
ISSN: 0929-6646
Titre abrégé: J Formos Med Assoc
Pays: Singapore
ID NLM: 9214933

Informations de publication

Date de publication:
Dec 2022
Historique:
received: 13 01 2022
revised: 05 05 2022
accepted: 11 07 2022
pubmed: 3 8 2022
medline: 24 11 2022
entrez: 2 8 2022
Statut: ppublish

Résumé

Pancreatic cancer is difficult to diagnose early since tumor markers have low sensitivity and specificity. We simultaneously measured serum carbohydrate antigen (CA) 19-9, pancreatic elastase-1, lipase, and amylase, and evaluated the accuracy of a single marker or a combination of two, three, or four markers in the diagnosis of pancreatic ductal adenocarcinoma (PDAC). Seventy-six patients with PDAC were included, and 75 patients with non-PDAC diseases were enrolled as the control group. Blood specimens were collected and analyzed for pancreatic elatase-1, CA19-9, amylase and lipase. Sensitivity, specificity, and accuracy for each individual marker and in combination were determined. In PDAC subjects, abnormal CA19-9 was seen most frequently at 80.3%, followed by pancreatic elastase-1 at 57.9%, lipase at 53.9%, and amylase at 51.3%. In non-PDAC subjects, the percentage of abnormal serum pancreatic elastase-1, CA19-9, lipase, and amylase were 50.7%, 41.3%, 40.0%, and 28.0%, respectively. The accuracy rate of amylase and CA19-9 results combined was 64.9% and was higher than the combination of other markers in the intersection set. In the union set, the group of amylase and CA19-9 combined and the group of lipase and CA19-9 combined had the highest accuracy at 66.2%. In the intersection and union set, the area under the curve of CA19-9 was the highest at 0.695. CA19-9 as a single marker is the most accurate in the clinical diagnosis of PDAC. Combination of lipase, amylase, or pancreatic elastase-1 results does not significantly increase the accuracy of PDAC diagnosis.

Sections du résumé

BACKGROUND BACKGROUND
Pancreatic cancer is difficult to diagnose early since tumor markers have low sensitivity and specificity. We simultaneously measured serum carbohydrate antigen (CA) 19-9, pancreatic elastase-1, lipase, and amylase, and evaluated the accuracy of a single marker or a combination of two, three, or four markers in the diagnosis of pancreatic ductal adenocarcinoma (PDAC).
METHODS METHODS
Seventy-six patients with PDAC were included, and 75 patients with non-PDAC diseases were enrolled as the control group. Blood specimens were collected and analyzed for pancreatic elatase-1, CA19-9, amylase and lipase. Sensitivity, specificity, and accuracy for each individual marker and in combination were determined.
RESULTS RESULTS
In PDAC subjects, abnormal CA19-9 was seen most frequently at 80.3%, followed by pancreatic elastase-1 at 57.9%, lipase at 53.9%, and amylase at 51.3%. In non-PDAC subjects, the percentage of abnormal serum pancreatic elastase-1, CA19-9, lipase, and amylase were 50.7%, 41.3%, 40.0%, and 28.0%, respectively. The accuracy rate of amylase and CA19-9 results combined was 64.9% and was higher than the combination of other markers in the intersection set. In the union set, the group of amylase and CA19-9 combined and the group of lipase and CA19-9 combined had the highest accuracy at 66.2%. In the intersection and union set, the area under the curve of CA19-9 was the highest at 0.695.
CONCLUSION CONCLUSIONS
CA19-9 as a single marker is the most accurate in the clinical diagnosis of PDAC. Combination of lipase, amylase, or pancreatic elastase-1 results does not significantly increase the accuracy of PDAC diagnosis.

Identifiants

pubmed: 35918272
pii: S0929-6646(22)00257-1
doi: 10.1016/j.jfma.2022.07.003
pii:
doi:

Substances chimiques

CA-19-9 Antigen 0
Amylases EC 3.2.1.-
Lipase EC 3.1.1.3
Biomarkers, Tumor 0
Pancreatic Elastase EC 3.4.21.36
Carbohydrates 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2601-2607

Informations de copyright

Copyright © 2022 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors have no conflicts of interest relevant to this article.

Auteurs

Chi-Ying Yang (CY)

Department of Internal Medicine, Digestive Medicine Center, China Medical University Hospital, Taichung, Taiwan.

Ro-Ting Lin (RT)

Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan.

Chi-Yi Chen (CY)

Division of Gastroenterology and Hepatology, Department of Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan.

Chun-Chieh Yeh (CC)

Department of Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan; Department of Surgery, Asia University Hospital, Taichung, Taiwan.

Chao-Ming Tseng (CM)

Department of Internal Medicine, E-DA Hospital, Kaohsiung, Taiwan.

Wen-Hsin Huang (WH)

Department of Internal Medicine, Digestive Medicine Center, China Medical University Hospital, Taichung, Taiwan.

Teng-Yu Lee (TY)

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.

Chia-Shen Chu (CS)

Department of Internal Medicine, Digestive Medicine Center, China Medical University Hospital, Taichung, Taiwan.

Jaw-Town Lin (JT)

Department of Internal Medicine, E-DA Hospital, Kaohsiung, Taiwan. Electronic address: jawtown@gmail.com.

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