Serologic markers in the diagnosis and management of pancreatic carcinoma

The low prevalence of pancreatic cancer remains an inherent obstacle to the development of effective screening tools in an asymptomatic population. However, these difficulties do not warrant nihilism. Development of effective serologic markers still offers the potential for improvement in our diagnostic capabilities. The accurate identification of patients with pancreatic cancer and the exclusion of disease in those with benign disorders remain important goals. While alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), carcinoembryonic antigen (CEA), and ribonuclease (RNase) can be largely dismissed as useful markers of pancreatic cancer, leukocyte adherence inhibition (LAI), pancreatic oncofetal antigen (POA), and galactosyltransferase isoenzyme II (GT-II) continue to show promise. Each of these markers currently requires further technical improvements to permit more widescale evaluation. The further refinement of monoclonal antibody defined markers such as gastrointestinal cancer antigens (GICA) may provide even more useful markers in the future. The development of effective serologic markers may help identify patients with early disease, and provide an impetus to develop more effective therapeutic strategies. It remains to be seen whether improvements in diagnostic modalities can be translated into improvement in clinical outcome.