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{{Pancreatic cancer}}
{{Pancreatic cancer}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}};{{PSD}}
==Laboratory Findings==
==Laboratory Findings==
:*Liver function tests: Jaundice (yellowing of the skin and eyes) is often one of the first signs of pancreatic cancer, but it can have many causes other than cancer.


The doctor may take [[blood]], [[urine]], and [[stool]] samples to check for [[bilirubin]] and other substances. Bilirubin is a substance that passes from the liver to the [[gallbladder]] to the [[intestine]]. If the common [[bile duct]] is blocked by a [[tumor]], the bilirubin cannot pass through normally. Blockage may cause the level of bilirubin in the blood, stool, or urine to become very high. High bilirubin levels can result from [[cancer]] or from noncancerous conditions.
:*Tumor markers: Tumor markers are substances that can sometimes be found in the blood when cancer is present. Two tumor markers may be helpful in pancreatic cancer:


[[Liver function test]]s can show a combination of results indicative of bile duct obstruction (raised [[conjugated bilirubin]], [[Gamma glutamyl transpeptidase|γ-glutamyl transpeptidase]] and [[alkaline phosphatase]] levels). [[CA19-9]] (carbohydrate antigen 19.9) is a [[tumor marker]] that is frequently elevated in pancreatic cancer.  However, it lacks sensitivity and specificity. When a cutoff above 37 U/mL is used, this marker has a sensitivity of 77% and specificity of 87% in discerning benign from malignant disease. CA 19-9 might be normal early in the course, and could be elevated due to benign causes of biliary obstruction.<ref>{{cite book |author=Frank J. Domino M.D.etc. |title=5 minutes clinical suite version 3 | year=2007 | publisher=Lippincott Williams & Wilkins | location=Philadelphia, PA}}</ref>
::*CA 19-9 is a substance often released into the blood by exocrine pancreatic cancer cells, although it often can’t be detected until the cancer is already advanced.


::*Carcinoembryonic antigen (CEA) is another tumor marker that might help find advanced pancreatic cancer in some people, but it is not used as often as CA 19-9.
:::*Neither of these tumor marker tests is accurate enough to tell for sure whether or not someone has pancreatic cancer. Levels of these tumor markers are not high in all people with pancreatic cancer, and some people who don’t have pancreatic cancer might have high levels of these markers for other reasons. Still, these tests can sometimes be helpful, along with other tests, in figuring out if someone has cancer.
:::*In people already known to have pancreatic cancer and who have high CA19-9 or CEA levels, these levels can be followed over time to help tell how well treatment is working. If all of the cancer has been removed, these tests can also be done to look for the cancer coming back.
::*Other blood tests: Other tests can help evaluate a person’s general health (such as kidney and bone marrow function). These tests can help determine if they’ll be able to withstand the stress of a major operation
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 17:16, 20 August 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2];Parminder Dhingra, M.D. [3]

Laboratory Findings

  • Liver function tests: Jaundice (yellowing of the skin and eyes) is often one of the first signs of pancreatic cancer, but it can have many causes other than cancer.
  • Tumor markers: Tumor markers are substances that can sometimes be found in the blood when cancer is present. Two tumor markers may be helpful in pancreatic cancer:
  • CA 19-9 is a substance often released into the blood by exocrine pancreatic cancer cells, although it often can’t be detected until the cancer is already advanced.
  • Carcinoembryonic antigen (CEA) is another tumor marker that might help find advanced pancreatic cancer in some people, but it is not used as often as CA 19-9.
  • Neither of these tumor marker tests is accurate enough to tell for sure whether or not someone has pancreatic cancer. Levels of these tumor markers are not high in all people with pancreatic cancer, and some people who don’t have pancreatic cancer might have high levels of these markers for other reasons. Still, these tests can sometimes be helpful, along with other tests, in figuring out if someone has cancer.
  • In people already known to have pancreatic cancer and who have high CA19-9 or CEA levels, these levels can be followed over time to help tell how well treatment is working. If all of the cancer has been removed, these tests can also be done to look for the cancer coming back.
  • Other blood tests: Other tests can help evaluate a person’s general health (such as kidney and bone marrow function). These tests can help determine if they’ll be able to withstand the stress of a major operation

References


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