Detection of small pancreatic cancers: Diagnostic potential of tumor markers, oncogenes, and tumor-suppressor genes

Abstract

The development of the monoclonal antibody technique has made it possible to use various tumor markers, such as CA 19-9, to detect pancreatic cancer. Although it has been reported that these markers are not sensitive or specific enough to detect small pancreatic cancers, nearly 70% of small pancreatic cancers (<4.0 cm) release pancreatic-cancer associated antigens. In addition, the use of serum tumor markers and ultrasound (US) as screening tools in the outpatient clinic is very effective in detecting pancreatic cancer, including small pancreatic cancers. Recently, observations of carcinogenesis in the pancreas in humans and in experimental models have suggested several cellular pathways for carcinoma of the pancreas. There is increasing evidence that pancreatic cancer results from an accumulation of dominant and recessive mutations in oncogenes and tumor-suppressor genes. Identification of the mutations that occur in pancreatic cancer may provide important information concerning the early stage of this disease. Although there are currently no methods of detecting the premalignant stages of pancreatic cancer, the study of genetic markers may play a central role in the development of techniques for the early detection of pancreatic cancer in the future. (For more detailed information on genetic changes in pancreatic cancer, see: PG Terhune and DS Longnecker,Do Oncogene and Tumor Suppressor Gene Abnormalities Vary with Type of Carcinoma of the Pancreas? J Hep Bil Pancr Surg (1995) 2:1–7.)