The value of CA 19 – 9 and endoscopic ultrasonography (EUS) in the detection of Pancreatic Ductal Adenocarcinoma (PDAC)

Introduction: EUS has been recommended when computer tomography (CT) is inconclusive for PDAC. CA19 – 9 has been suggested as a potential marker in the detection of PDAC. Aims: The aim of our study was to assess the utility of CA19 – 9 and EUS in PDAC detection after a negative abdominal CT in a selected population of pancreatic EUS referrals. Methods: A retrospective study of patients who underwent radial EUS between 2012 and 2015 in our institution, with the aim to confirm the presence or absence of PDAC subsequent to no tumor detection by abdominal CT compared normal with elevated Ca 19 – 9 level. Results: 46 patients (20 male, 26 female, mean age 63.54 ± 18 years) were recruited in the study. 24 patient had abdominal pain, 3 fever, 9 weight lost and 18 patients were asymptomatic. EUS revealed 18 PDAC and 28 EUS were negative. The CA 19 – 9 level was normal in 8 and elevated in 10 patients with PDAC, and it was normal in 23 and elevated in 5 patients with negative EUS. Sensitivity, specificity and positive and negative predictive value of CA19 – 9 were 55.5%, 82.1%, 66.6% and 74.1%, respectively. Conclusions: EUS is recommended to be performed, when PDAC is suspected, but CT is negative. Ca 19 – 9 is not a reliable diagnostic tool for PDAC.