Pancreatic cancer laboratory tests

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Sudarshana Datta, MD [2]


Laboratory findings in pancreatic cancer patients are often non specific and include abnormal liver function tests such as elevated serum bilirubin levels (conjugated and total), elevated alkaline phosphatase and gamma-glutamyl transpeptidase levels. Patients may have evidence of malnutrition, mild normocytic normochromic anemia and elevated CA 19-9 levels. CA 19-9 levels play an important role in prognosis, treatment and assessment of the efficacy of therapy in pancreatic cancer patients.

Laboratory Findings

Routine laboratory tests in pancreatic cancer patients are often non-specific.

CA 19-9

Role in prognosis:[6][7][8][9][10][11][12]

  • Preoperative values above 50 U/mL have higher recurrence.
  • High levels indicate poorer outcome and low chance of resectability

Role in treatment:[5][13][14]

  • To determine the respectability potential, CA 19-9 levels are used as an adjunct to imaging studies.
  • Staging laproscopy prior to resection is not required in patients presenting with low levels of CA 19-9 (< 100 IU) as they are unlikely to have occult metastatic disease.

Role in assessing response to treatment:[6][15][13][16]


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  2. . doi:10.3978/j.issn.1000-9604.2015.07.03. Missing or empty |title= (help)
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  8. Pleskow DK, Berger HJ, Gyves J, Allen E, McLean A, Podolsky DK (1989). "Evaluation of a serologic marker, CA19-9, in the diagnosis of pancreatic cancer". Ann. Intern. Med. 110 (9): 704–9. PMID 2930108.
  9. Cwik G, Wallner G, Skoczylas T, Ciechanski A, Zinkiewicz K (2006). "Cancer antigens 19-9 and 125 in the differential diagnosis of pancreatic mass lesions". Arch Surg. 141 (10): 968–73, discussion 974. doi:10.1001/archsurg.141.10.968. PMID 17043274.
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  11. Paganuzzi M, Onetto M, Marroni P, Barone D, Conio M, Aste H, Pugliese V (1988). "CA 19-9 and CA 50 in benign and malignant pancreatic and biliary diseases". Cancer. 61 (10): 2100–8. PMID 2834038.
  12. Molina V, Visa L, Conill C, Navarro S, Escudero JM, Auge JM, Filella X, Lopez-Boado MA, Ferrer J, Fernandez-Cruz L, Molina R (2012). "CA 19-9 in pancreatic cancer: retrospective evaluation of patients with suspicion of pancreatic cancer". Tumour Biol. 33 (3): 799–807. doi:10.1007/s13277-011-0297-8. PMID 22203495.
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  14. Goonetilleke KS, Siriwardena AK (2007). "Systematic review of carbohydrate antigen (CA 19-9) as a biochemical marker in the diagnosis of pancreatic cancer". Eur J Surg Oncol. 33 (3): 266–70. doi:10.1016/j.ejso.2006.10.004. PMID 17097848.
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