Diagnostic Value of Tissue Polypeptide Specific Antigen in Patients with Pancreatic Carcinoma

Abstract

We evaluated the clinical utility of a new tumor marker tissue polypeptide specific antigen (TPS) in the diagnosis of pancreatic carcinoma. Serum concentrations were determined in 113 patients with jaundice, in 18 patients with laboratory values suggesting cholestasis and in 60 patients with suspicion of chronic pancreatitis or pancreatic tumor. Twenty-four of these 191 patients had pancreatic carcinoma and 2 patients had carcinoma of the papilla of Vater. The highest median serum TPS value was detected in patients with malignant liver disease, but high median values were also measured in patients with pancreatic cancer, bile duct cancer or benign liver disease. The sensitivity of TPS was 50.0%, with a specificity of 73% and an efficiency of 70%. In comparison with carcinoembryonic antigen (CEA), CA 50 and CA 242, the TPS test showed lower sensitivity, but the differences in specificity and negative predictive value were considerably smaller. The utility of TPS as a complementary test was also analyzed. When TPS was combined with other marker tests, their specificities clearly improved, being highest in the combination of TPS and CA 242 (92.5%). In this combination, efficiency and positive likelihood ratio were also clearly better (85% and 5.6) than those of the marker tests alone. In conclusion, TPS seems less accurate than CEA, CA 50 or CA 242 in the diagnosis of pancreatic cancer, but because of its different nature it may be considered to be used as a complementary test.

Clinical Value of Serum Neopterin, Tissue Polypeptide-Specific Antigen and CA19-9 Levels in Differential Diagnosis between Pancreatic Cancer and Chronic Pancreatitis

“…Our results are in agreement with other studies which reported that higher serum levels of CA19-9 were associated with the presence of distal metastases and worse prognosis of patients with pancreatic cancer [17,18]. In contrast, other authors have not found the relationship between CA19-9 value and the clinical advancement of pancreatic cancer [16,19]. …”

“…The last analyzed marker – TPS – in our and other studies was also significantly elevated in patients with PA [11,16]. It is known from the literature that TPS serum levels increased in other neoplastic diseases.…”

“…It has been suggested that TPS reflects the activity of tumor growth, however its clinical utility in cancer diagnosis is controversial [11,12,13,14]. In some studies, TPS has been found to be superior to CA19-9 [15,16], but inferior in others [14,17]. The aim of our study was to compare the clinical usefulness of CA19-9, neopterin and TPS serum levels in differential diagnosis of PA and CP as well as to assess their possible prognostic value.…”

TPS, CA 19-9, VEGF-A, and CEA as Diagnostic and Prognostic Factors in Patients with Mass Lesions in the Pancreatic Head

“…The tumour markers are rather crude measures of resectability and prognosis in patients with pancreatic cancer. Despite the fact the marker levels in our study were overall slightly lower than in previous studies of the same markers applied as diagnostic (17,19,21,22) and prognostic markers (4,10,14,23), none of the included patients were found to fit for pancreatic resection.…”

“…In some studies CA 19-9 has been found to be superior to TPS (16)(17)(18), whereas in another study the contrary was shown (19). We found that the AUC was slightly higher for TPS than for CA19-9 and CEA, but the differences were not significant.…”