[Comparative study of the role of CA 19-9, CA 72-4 and CEA tumor antigens in the diagnosis of pancreatic cancer and other gastrointestinal malignant diseases].

The diagnostic value of CA 19-9, CA 72-4 and CEA was evaluated in 291 patients (including 39 with pancreatic cancer, 32 with gastric cancer, 36 with colorectal cancer and 40 with chronic pancreatitis). These markers were determined in the serum by chemiluminescence immunoassay (CA 72-4) or microparticle enzyme immunoassay (CA 19-9 and CEA) methods. In serodiagnostic evaluations relating to pancreatic cancer, CA 19-9 proved superior to CA 72-4 and CEA (sensitivity: 79.5 vs. 56.5 and 62.5%; specificity: 84.1 vs. 77.9 and 77.2%; diagnostic accuracy: 85.9 vs. 75.8 and 75.7%, respectively). For gastric carcinoma, CA 72-4 appeared the most sensitive: 53.1% of all patients were identified with a specificity of 78.9% and a diagnostic accuracy of 75.4%. In the diagnosis; of colorectal cancer, CEA exhibited the highest sensitivity (63.9%) and diagnostic accuracy (76.2%). Elevated CA 19-9 levels were obtained in only 7.7% of patients with chronic pancreatitis. Tumor marker determination is useful in the diagnosis of gastrointestinal malignancies: the marker of choice in pancreatic cancer is CA 19-9, in gastric cancer it is CA 72-4 and in colorectal cancer it is CEA. CA 19-9 is effective in discriminating between pancreatic cancer and chronic pancreatitis.