CA 19-9 Concentration in Peripheral and Portal Blood of Patients Operated on for Pancreatic Tumor
Pancreatic cancer is one of the most common malignant diseases in the world. Morbidity rate increases and now reaches around 200 000 new cases yearly. Poor prognosis mainly results from usually late diagnosis and non-specific symptoms. Despite of advances in radiological diagnosis of pancreatic diseases, differentiation between malignant and inflammatory pancreatic tumors still remains difficult. The aim of the studywas the assessment of clinical utility of CA 19-9 in peripheral and portal blood of patients with pancreatic tumor. Material and methods.66 patients were hospitalized at the Department of General and Transplant Surgery between October 2010 nad July 2012 due to pancreatic tumor. Blood samples were collected from peripheral vein before surgery and intraoperatively from the portal vein to measure CA 19-9 concentration. 57 patients were diagnosed with malignant tumor and 9 with inflammatory lesion. Metastases to the liver were present in 7 of all patients. Radical surgery (Whipple’s procedure in 27 cases) were performed in 34 patients. Results.Significantly higher CA 19-9 concentration in the peripheral blood and in the portal blood as well was found in the pancreatic cancer group than in the inflammatory lesions group (51.2 vs <3 and 52.1 vs 6.3 respectively). Marker concentration in case of malignant lesions was significantly higher in the portal blood than in the peripheral blood (52.1 vs 51.2; p<0.05). CA 19-9 concentration of patients with malignant pancreatic tumors but without metastases to the liver was significanlty higher in the portal blood than in the peripheral blood (19.32 vs 18.65; p<0.01). Conclusions.Determination of the CA 19-9 concentration not only in the peripheral blood but in the portal blood as well might be a useful diagnostic tool in order to differentiate between the malignant and inflammatory pancreatic tumors. We did not see any statistically significant dependency between the CA 19-9 concentrations in the peripheral blood and portal blood and if the surgery was radical or not, but significantly higher concentrations of CA 19-9 in the portal blood than the peripheral blood among the patients suffering from the malignant pancreatic tumor without metastases to the liver might be useful tool when decisions on performing pancreatoduodenectomy are being made since this surgery is forborne from when metastases are present.
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