Pancreatic cancer is a malignant tumor within the pancreatic gland. Each year about 32,000 individuals in the United States are diagnosed with this condition, and more than 60,000 in Europe. Depending on the extent of the tumor at the time of diagnosis, the prognosis is generally regarded as poor, with few victims still alive 5 years after diagnosis, and complete remission still extremely rare.

About 95 percent of pancreatic tumors are adenocarcinomas. The remaining 5 percent include other tumors of the exocrine pancreas (e.g. serous cystadenomas), acinar cell cancers, and pancreatic neuroendocrine tumors (such as insulinomas). These tumors have a completely different diagnostic and therapeutic profile, and generally a more favorable prognosis.

7B2

• a useful marker for pancreatic islet cell tumors, in particular nonfunctioning tumor. PMID: 1662184

CA19-9 (carbohydrate antigen 19-9)

• currently the most widely used serum tumor marker in pancreatic cancer (PC). CA 19-9 kinetics under chemotherapy may possibly serve as a useful surrogate marker for time to tumor progression and survival in advanced PC. PMID: 17264524
• An elevated serum level of the CA 19-9 in the presence of pancreatic lesions usually suggests malignant nature of the lesion. A high CA 19-9 level is typical of advanced inoperable pancreatic cancer. PMID: 16146081
• strongly expressed in most tissue specimens from pancreatic carcinomas. PMID: 2180502
• a good marker for carcinoma of the pancreas and that it can be commonly used. PMID: 3865571, PMID: 6209082
• As the most extensively evaluated marker, CA 19-9 should be used in contemporary algorithms for the diagnosis of pancreatic cancer. Elevated values should be repeated after relief of jaundice. PMID: 17097848
• a more sensitive and specific marker of pancreatic cancer than other serologic markers and should be a useful test in the patient with suspected pancreatic disease. PMID: 2930108

CA50

• marginally beneficial for the diagnosis, but very useful for the follow-up of patients with pancreatic cancers. PMID: 7561549
• a promising tumor marker in the detection and follow-up of patients with pancreatic cancer. PMID: 3470260
• The initial CA 50 value can help to indicate in which patients a pancreatic malignancy should be suspected. PMID: 9158191

CA242

• the advantage of CA 242 compared to CA 19-9 is that its specificity is higher than that of CA 19-9 in the diagnosis of pancreas cancer. PMID: 14571813
• a new tumor marker for pancreatic cancer. PMID: 8431849
• a new tumour marker for pancreatic cancer: a comparison with CA 19-9, CA 50 and CEA. PMID: 8080735

CA494

• a new tumor marker for the diagnosis of pancreatic cancer. PMID: 8449599

CAM 17.1

• a new diagnostic marker in pancreatic cancer. PMID: 8980403

CAR-3

• Because of its high specificity for pancreatic carcinomas compared to chronic pancreatitis, CAR-3 seems a promising marker for distinguishing between neoplastic and chronic inflammatory diseases of the pancreas, whose differential diagnosis is difficult. PMID: 2977786

Cathepsin E (CTSE)

• the expression of CTSE is associated with the pathogenesis of pancreatic ductal adenocarcinoma, that CTSE in the pancreatic juice seems to be a useful marker for a definitive diagnosis and that CTSE may be expressed at a relatively early stage of multistep carcinogenesis in pancreatic lesions. PPMID: 8759606

DDX48

• may have clinical utility for the improved diagnosis of pancreatic cancer. PMID: 15796914

Discetylspermine

• urine discetylspermine is a highly sensitive and specific novel marker for bilio-pancreatic carcinoma. PMID: 15164602

Fascin and HSP47

• are novel tumor markers with potential diagnostic and therapeutic implications for pancreatic carcinoma. PMID: 12109856

Fucosylated haptoglobin

• a novel marker for pancreatic cancer. PMID: 16385567

KOC

• a sensitive and specific marker for carcinomas and high-grade dysplastic lesions of the pancreatic ductal epithelium. PMID: 15644775

L1

• specifically expressed in poorly-differentiated pancreatic neuroendocrine carcinomas that are known to have the worst prognosis. L1 might be a marker for risk prediction of patients diagnosed with pancreatic neuroendocrine carcinomas. PMID: 16440424

Mesothelin

• a new marker for pancreatic adenocarcinoma identified by gene expression analysis. Mesothelin overexpression in pancreatic adenocarcinoma has potential diagnostic, imaging, and therapeutic implications. PMID: 11751476

MLS102

• superior to V. illosa agglutinin in distinguishing malignant from normal and nonmalignant pancreatic tissues in needle biopsies. PMID: 7846011

MUSE 11 antigen

• may be useful for the diagnosis of pancreatic cancers. PMID: 1674290

Neurotensin receptors

• a new marker for human ductal pancreatic adenocarcinoma. PMID: 9616318

NSE (neuron-specific enolase)

• serum NSE levels can aid in the diagnosis and monitoring of the course of nonfunctining islet cell carcinoma. PMID: 6295198

p16INK4a

• a prognostic marker in resected ductal pancreatic cancer. PMID: 11753042

POA (pancreatic oncofetal antigen)

• the determination of serum POA would be useful in the diagnosis of pancreatic cancer. PMID: 3888788

PSCA

• may prove to be a valuable pancreatic cancer tumor marker. PMID: 16957968

PTHrP (Parathyroid hormone-related protein)

• can serve as a tumor marker in animal models of pancreatic cancer and may be a useful tumor marker for clinical pancreatic adenocarcinoma. PMID: 11893937

RRCAS1

• might be a significant tumor marker for pancreatic adenocarcinoma and an unfavorable predictor for prognosis of patients who have undergone surgical resection. PMID: 11992411
• the combination of RCAS1 and CA19-9 is highly sensitive for pancreatic carcinoma. PMID: 16127752

REG4

• a promising tumor marker to screen early-stage pancreatic ductal adenocarcinoma (PDAC), and also that neutralization of REG4 by the antibody may offer novel potential tools for the treatment of PDAC. PMID: 16918991

S100A6

• may be a promising therapeutic target for pancreatic cancer. PMID: 16278400

SPan-1

• elevated in sera of patients with exocrine pancreatic cancer. SPan-1 may be considered as an additional useful and reliable serum marker for the detection of this neoplasm, but it does not significantly improve the diagnostic accuracy obtained with CA 19.9. PMID: 11605732
• a new tumor marker for pancreatic cancer, has a high sensitivity and specificity for pancreatic cancer. It is almost equivalent to CA19-9 assay. PMID: 2311067

Survivin

• expression in pancreatic cancer tissues could be a useful prognostic marker in pancreatic cancer patients. PMID: 15300213

Syndecan-1

• Stromal syndecan-1 expression is an independent prognostic marker in pancreatic cancer. PMID: 15886501

TPS (tissue polypeptide specific antigen)

• more useful than CA 19-9 in the differential diagnosis of pancreatic carcinoma and chronic pancreatitis. PMID: 10897004

Transferrin Receptor (TFRC)

• a marker of malignant phenotype in human pancreatic cancer and in neuroendocrine carcinoma of the pancreas. PMID: 15177502

Trk tyrosine kinase receptor

• a biologic marker for cell proliferation and perineural invasion of human pancreatic ductal adenocarcinoma. PMID: 11295066

TTAG-72

• Serum TAG-72 expression seems to be more frequent in poorly-differentiated tumors than in well-differentiated cancers (56 vs 30% positivity rate). PMID: 7930777

Tu M2-PK (Tumor M2-pyruvate inase)

• has a satisfactory sensitivity but a poor specificity in the diagnosis of pancreatic cancer. Used together with CA 19-9, the sensitivity increases considerably. PMID: 15387337
• has comparable sensitivity but higher specificity than the reference tumor marker CA19-9 in pancreatic cancer. PMID: 9329593

Other Pancreatic Cancer Markers

• the tumor marker change after GEM treatment may be a predictor of preferable prognosis in patients with pancreatic cancer. PMID: 15984518
• molecular beacon-based imaging of expression of tumor marker genes has potential for the development of novel approaches for the detection of pancreatic cancer cells. PMID: 15917666
• Tumor marker profiles analysed with the fuzzy logic method may have an improved sensitivity compared with single standard tumor markers. The diagnostic efficacy should be proved in patients with pancreatic tumors of unknown origin. PMID: 11326646