Sensitive serum markers for detecting pancreatic cancer.

Serum amylase, immunoreactive elastase (IRE), carcinoembryonic antigen (CEA), and carbohydrate antigen (CA 19-9) were measured in 40 patients with pancreatic cancer. IRE and CA 19-9 were further assayed in nonpancreatic malignancies (n = 98) and chronic nonmalignant disease (n = 194). In pancreatic cancer, elevated values were observed for amylase in 30% of the patients, for IRE in 70%, for CEA in 28%, and for CA 19-9 in 68%. Elevation of IRE and/or CA 19-9 was found in 95% of the 40 patients. Elevated serum IRE was observed more frequently in head cancer and resectable cancer, whereas elevation in CA 19-9 occurred more often in body-tail cancer and unresectable cancer. Elevation of serum IRE tends to occur at earlier stages of pancreatic cancer. No one test is adequate for the accurate diagnosis of pancreatic cancer. However, the two assays complement each other, and their combined use would provide a sensitive clue for tentative diagnosis of pancreatic cancer.