Improved Diagnostic Accuracy of Pancreatic Diseases with a Combination of Various Novel Serum Biomarkers - Case Control Study from Manipal Teaching Hospital, Pokhara, Nepal


Background: Pancreatic cancer is a distressing disease with a miserable prospects and early recognitionremains a challenge due to ubiquitous symptomatic presentation, deep anatomical location, and aggressiveetiology. False positives and problems in distinguishing pancreatitis from adenocarcinoma limit the use of CA 19-9as both disorders can present with similar symptoms and share radiographic physiognomies. This study aimedto assess the relative increase in accuracy of diagnosing the patients with chronic pancreatitis, benign neoplasmof pancreas and adenocarcinomas with CA 19-9, haptoglobin, and serum amyloid A in comparison to CA 19-9alone. Materials and
Methods: This hospital based case control study was carried out in the Departments ofMedicine and Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal, between 1st January 2010 and 31stDecember 2011. The variables assessed were age, gender, serum CA19-9, serum haptoglobulin, serum Amyloid A.The data were analyzed using Excel 2003, R 2.8.0 Statistical Package for the Social Sciences (SPSS) for WindowsVersion 16.0 (SPSS Inc; Chicago, IL, USA) and the EPI Info 3.5.1 Windows Version.
Results: Out of 197 casesof pancreatic disease, maximum number of assumed cases were of adenocarcinoma of pancreas (95). Numberof males (59) were more than females (36) in assumed cases of adenocarcinoma of pancreas. The mean values ofCA19-9 raised considerably in cases of chronic pancreatitis, benign neoplasm and adenocarcinoma of pancreaswhen compared to controls. The highest augmention in CA19-9 values were in cases of adenocarcinoma ofpancreas. The p-value indicates that in cases of chronic pancreatitis, there was not significant increase in precisionof diagnosis.
Conclusions: These statistics established that haptoglobin and SAA are useful in discriminatingcancer from benign conditions as well as healthy controls.