The Diagnosis Value Of Endoscopic Ultrasonography Combined With Three Serum Tumor Markers In Pancreatic Cancer

Background and Objective:To study the value of endoscopic ultrasound and serum tumor markers CA19-9,CA125and CEA in diagnosis of pancreatic cancer,especially the combined use of EUS and the three serum tumor markers.Methods:This retrospective study included 134 patients with pancreatic neoplasms identified by pathological diagnosis at the Division of Hepatobiliary and Pancreatic Surgery,First Affiliated Hospital,School of Medicine,Zhejiang University between January 1st 2013 and December 31st 2014,and 22 persons undergoing health examination during the same period in our hospital.We investigated the value of endoscopic ultrasound and serum tumor markers CA19-9,CA125 and CEA in diagnosis of pancreatic cancer,especially the combined use of EUS and the three serum tumor markers.Results:Among 134 pancreatic neoplasm cases including 89 pancreatic cancers(66.42%)and 45 non-cancerous pancreatic tumors(33.58%),47 patient did not have endoscopic ultrasound guided fine needle aspiration(EUS-FNA),which comprised 32.10%of the total cases.In 87 cases with EUS-FNA,the diagnosis of 19 cases(21.84%)were inconsistent with post-operative pathologic results.In pancreatic cancer group,elevation of CA 19-9 was detected in 73 cases,CA 125 in 39 cases and CEA in 28 cases.In non-cancer group,elevation of CA 19-9 was detected in 17 cases,CA 125 in 6 cases and CEA in 20 cases.Comparisons among pancreatic cancer group,non-cancer group and heath control group showed statistical difference.Based on pathologic results of 134 cases,sensitivities of EUS,CA 19-9,CA 125and CEA in diagnosis of pancreatic cancer were 89.89%,82.02%,44.94%and 32.00%,and specificities were 53.33%,62.22%,86.67%and 55.56%.For combined use of EUS and three tumor marker,sensitivity,specificity,positive predictive value and negative predictive value was 89.89%,89.89%,94.12%and 81.63%,respectively.Conclusion:The combination of endoscopic ultrasonography and three serum tumor markers(CA 19-9,CA 125 and CEA)in the diagnosis of pancreatic cancer improves specificity(88.89%),positive predictive value(94.12%)and negative predictive value(81.63%),without decreasing the sensitivity(89.89%),which is highly consistent with pathologic results,indicating important value in the diagnosis and differential diagnosis of pancreatic cancer(Kapp=0.771,P=0.000<0.05).