Values of serum carcinoembryonic antigen and elastase 1 in diagnosis of pancreatic carcinoma.

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Abstract
Carcinoembryonic antigen (CEA) and elastase I in the serum were determined by enzyme immunoassay and radioimmunoassay, respectively, in 224 healthy subjects, 49 patients with pancreatitis, 53 patients with pancreatic carcinoma and 129 patients with cancer in other organs. The CEA concentrations in the serum were significantly higher in patients with pancreatic carcinoma than in those with pancreatitis. This concentration was not a satisfactory indicator of pancreatic carcinoma localized to allow irradication by resection as it was raised in only 47% of the patients. High CEA concentrations were also slightly, but not significantly, more frequent in patients with cancer of the pancreatic body or total and unresectable cancer or cancer of > 6.0 cm in diameter than in those with cancer of the pancreatic head, resectable cancer or cancer of < 6.0 cm diameter. Serum elastase 1 was raised in only 42% of the patients with pancreatic carcinoma and could not be used to distinguish patients with pancreatic carcinoma from those with pancreatitis. In contrast with CEA, its concentration was abnormally high significantly more frequently in patients with cancer of < 6.0 cm in diameter than in those with larger tumors. It was also raised slightly, but not significantly, more frequently in those with cancer of the pancreatic head and in patients with resectable cancer than in those with unresectable cancer. A combination of these 2 tests raised specificity for pancreatic carcinoma. In particular, it raised the diagnostic rates of cancer cases of the pancreatic head, resectable cancer and cancers of < 3.0 cm and 3.0-6.0 cm in diameter. A combination of measurements of CEA and elastase 1 in the serum is very useful for early detection of pancreatic carcinoma.