If there is a suspicion of the formation of a malignant tumor of the pancreas, the specialist must prescribe a blood test that determines the oncomarker of the pancreas. This study is one of the first used for early detection of the oncological process. Several types of substances that are produced by the tumor are installed, and they are installed by special laboratory research methods.
Indications for research
There are several pathological conditions that require testing for pancreatic tumor markers for timely diagnosis of the pathological process:
- chronic pancreatitis;
- cystic formations and other benign tumors of the gland, especially those that increase in size when dynamic ultrasound is performed;
- formation of clinicalpicture, which is typical for oncology of the gland;
- pseudotumorous pancreatitis;
- monitoring the effectiveness of the operation (how completely removed the formation) and conservative therapy (chemotherapy, radiation) for pancreatic cancer;
- to establish metastatic lesions of other organs, if there are no clinical symptoms of metastases;
- to predict the course of cancer.
Rules of preparation for the study
To prepare for the test for pancreatic tumor markers, you need to follow some simple recommendations:
- Do not drink or eat anything other than non-carbonated clean water for ten hours before the test: proteins entering the blood after eating can cause a false positive test result.
- Do not drink alcohol for at least two days before the test.
- Not less than a day before the examination, you need to give up sweets, fried, s alty, fatty foods and other foods that enhance the secretion of pancreatic juice, as well as intestinal motility and other digestive organs.
For two weeks before the analysis for pancreatic tumor markers, do not take any medicines in any form of release (ointments, suppositories, injections, tablets, etc.), including alternative medicine preparations (infusions and herbal teas). If the patient takes medicines necessary for life, for example,anticonvulsants for epilepsy, blood-thinning, antihypertensive drugs, then they cannot be canceled. However, it is imperative to inform your doctor about their use before taking a study on pancreatic tumor markers.
Physical work and various sports should not be done at least one day before the analysis. It is also necessary to avoid neuro-emotional stress.
It is forbidden to smoke before the study at least for a day, because due to smoking, the secretion of the stomach increases, the synthesis of pancreatic juice and bile synthesis reflexively increases, which may affect the results of the study.
The procedure for passing the analysis
To be tested for tumor markers of pancreatic cancer, a person needs to donate venous blood. It is better to take the material on an empty stomach in the morning. Blood (five milliliters) is taken from the patient from the cubital vein. To make the result more informative, it is necessary to properly prepare for such a study.
A specialist in laboratory diagnostics after blood donation conducts several studies (ELISA method) and writes out a conclusion. The result will be ready in a day or earlier if necessary. The results are interpreted only by the attending oncologist, who is familiar with the patient's medical history, his concomitant diseases, in which the number of tumor markers is increased.
When detecting their high content in almost all cases, it will be necessary to conduct studies again. Control tests should be performedin the same medical and diagnostic institution where the primary one, since the indicators of different laboratories most often differ.
The type of markers and the frequency of the study is set individually by the attending physician.
What is the norm for pancreatic tumor markers?
Norm and deviations in the results of the study
Multiple excess of normal values when determining the content of substances, that is, markers of a malignant tumor, almost always indicates the presence of such a tumor in the body. The higher the score, the more likely it is to have cancer. The presence of metastases and the size of the neoplasm are also judged by how much the content of oncomarkers is exceeded relative to the norm.
Normal values of tumor markers, which are determined in case of suspected pancreatic cancer:
CA19-9 - no more than 40 IU/ml;
M2-RK – no more than 15 units/ml;
CA50 - no more than 23 units / ml;
CA72-4 - no more than 6.9 IU/ml;
CA125 - 22-30 IU/ml;
CA242 - no more than 30 IU/ml;
AFP - no more than 10 IU/ml.
The norm of tumor markers is often exceeded in case of pancreatic neoplasm.
When the results obtained deviate from normal values, an additional examination of the person is necessary: CT, ultrasound of the peritoneal cavity organs are prescribed, then a biopsy is performed when a tumor-like formation is diagnosed in the pancreas.
Tumor markers of pancreatic neoplasms
For pancreatic cancertumor markers are substances secreted by this tumor into the blood. According to the chemical structure, these are protein-carbohydrate compounds (glycoproteins). To diagnose a gland tumor, look at the primary and secondary markers in the study.
Which pancreatic tumor markers are the most informative, interesting to many.
Main markers
Among the main oncomarkers of oncological pathology of the gland, which are diagnosed without fail if there is a suspicion of cancer, are glycoproteins CA19-9 and CA50. It is optimal to simultaneously check the values of these two compounds, since the determination of one tumor marker is ineffective.
If both indicators increase at once, the disappointing diagnosis will be almost 100% confirmed.
CA50
Detection of this sialoglycoprotein is the most informative test for a pancreatic tumor: if CA50 is elevated, there is a high probability of an oncological process in the pancreas, since it is an organ-specific antigen.
The disadvantage of this study is its high price, compared with the establishment of another main tumor marker - CA19-9 - pancreas.
CA19-9
The synthesis of this glycoprotein is carried out by the cells of the epithelium of the gallbladder, intestines, pancreas, bronchi and other parts of the gastrointestinal tract, and therefore its increase indicates oncology of almost any digestive organ.
When a patient is diagnosed with cirrhosisliver, cholecystitis, pancreatitis, hepatitis, cholelithiasis, systemic connective tissue pathologies, he will have a slightly elevated C19-9, but not much compared to the norm.
A blood test for a pancreatic tumor marker is one of the most informative in diagnosing cancer: CA19-9 is significantly increased in 80% of situations with such a disease. It is also necessary to determine it for the choice of treatment tactics: if the content of this compound is more than 1000 IU / ml, surgical intervention is not required due to the high probability of the presence of metastases. In this case, other methods of therapy are selected.
To monitor the effectiveness of treatment or establish relapses, dynamic analyzes of just such a tumor marker are done.
In some patients, there is insensitivity to CA19-9, or this substance is not synthesized in the body at all, even with malignant inflammation. The analysis in such cases will be false-negative, and you cannot rely on it: you will need to test for other tumor markers.
Additional markers
This variety of pancreatic tumor markers includes compounds that are determined in the patient's blood with any malignant neoplasms.
CA72-4. It is a carcinomaembryonic antigen that rises in 80% in pancreatic cancer. It is also found during pregnancy, pancreatitis, benign formations. A high level of such a substance indicates the presence of metastases in the lymph nodes.
AFP, oralpha-fetoprotein is normally synthesized in utero by the yolk sac in the developing embryo. In the body of adults, its production is carried out by liver cells. An increase in the concentration of this substance indicates liver carcinoma or pancreatic cancer. The AFP test must be taken simultaneously with other antigens.
M2-RK
Tumor pyruvate kinase M2 indicates a change in metabolism. This happens due to the appearance of a malignant tumor.
CA242
The production of this compound occurs by the mucous membranes of the intestines and the excretory pancreatic ducts. A high content of CA242 indicates cancer of the large and small intestines, pancreatitis, pancreatic oncology, gastric ulcer. This oncomarker is determined only in combination with the main ones.
CA125
Such a substance is produced by the epithelium of the respiratory organs, digestion in the fetus. CA125 in the adult organism is secreted only by the tissues of the respiratory system. Its content increases in cancer of the pancreas, stomach, liver, pregnancy, pancreatitis, degenerative and inflammatory liver pathologies.
