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Pancreas Tumor Markers

written by: Veronica Mitchell • edited by: Diana Cooper • updated: 12/13/2010

There are a number of pancreas cancer tumor markers which can be used in the diagnosis and management of pancreatic cancer including CA19-9 and galactosyltransferase II.

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    Tumor markers are molecules which can be used in the diagnosis or management of tumors because their occurrence in blood or tissue gives doctors information about the presence, likelihood or state of progression of types of cancer.[1] Unfortunately there is no known marker which can indicate with certainty the presence or absence of pancreatic cancer, but there are a number of pancreas cancer tumor markers which are useful in the diagnosis and treatment of the condition.

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    Carcinoembryonic Antigen

    Also known as CEA, carcinoembryonic antigen is a protein often associated with tumors and the developing fetus, but also found in many tissues in the body.[2] Elevated blood CEA levels are found in a variety of cancers including colon, pancreatic, gastric, lung and breast cancer.

    CEA has been used as a marker for pancreatic cancer since 1965, but it has more recently been replaced by more specific and sensitive markers. It is not a useful diagnostic marker as it may be elevated in the absence of cancer, in particular in smokers. However it has been used with some success as a prognostic tool in predicting the chances of survival following operation in patients with advanced pancreatic cancer.[3]

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    CA19-9 May Be Used to Identify Malignancy

    CA19-9 is an antibody generated by the patient’s immune system against carcinoma cell lines. It is elevated in 71-93% of pancreatic cancer, and thus provides a more sensitive measure of malignancy than CEA.[4] It can also be used as a prognostic factor: patients with higher CA19-9 levels being less likely to survive.[5]

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    Galactosyltransferase II

    Galactosyltransferase II is an enzyme which has been shown to be elevated in a number of malignancies including pancreatic cancer. It is useful because it is more specific and sensitive in distinguishing between malignant and benign disease than other tumor markers.[6] In combination with imaging techniques it provides a useful diagnostic tool, but serum levels of galactosyltransferase II do not allow doctors to distinguish between pancreatic cancer and other intestinal neoplasms.

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    Insulin as a Marker for Islet Cell Tumor

    The majority of pancreatic tumors affect the exocrine cells of the pancreas, but for islet cell tumor, levels of the hormone insulin can be used as a marker. Other chemicals such as the neurotransmitter synaptophysin have also been shown to be useful markers for this type of pancreatic cancer.[7]

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    Other Markers May Be Elevated in Pancreatic Cancer

    There are a number of other markers which may be elevated in pancreatic cancer, including alpha-fetoprotein (AFP), which is more commonly associated with cancer of the liver; and CA-125, an important marker in ovarian cancer.[8]

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    Citations

    [1][2][8]Tumor Markers; AFP, HCG, CA-125" TCCancer.com

    [3][4] J Lundin, PJ Roberts, P Kuusela, C Hagland “The Prognostic Value of Preoperative Serum Levels of CA19-9 and CEA in Patients with Pancreatic Cancer" British Journal of Cancer 69:515-519 (1994)

    [5] NR Maisey, AR Norman, A Hill “CA19-9 as a Prognostic Factor in Inoperable Pancreatic Cancer: The Implication for Clinical Trials" British Journal of Cancer 93:740-743 (2005)

    [6] DK Podolsky, Ms McPhee, E Alpert “Galactosyltransferase Isoenzyme II in the Detection of Pancreatic Cancer: Comparison with Radiologic, Endoscopic and Serologic Tests" New England Journal of Medicine 304:1313-1318 (1981)

    [7] G Chejfec, S Falkmer L Grimelius “Synaptophysin. A New Marker for Pancreatic Neuroendocrine Tumors" American Journal of Surgical Pathology 11:241-247 (1987)

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