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Diagnosis of cancer of the pancreas

CT scan of the abdomen, demonstrating a large cancer of the pancreas (thick red arrows) and multiple liver metastases (thin red arrows)
CT scan of the abdomen, demonstrating a large cancer of the pancreas (thick red arrows) and multiple liver metastases (thin red arrows)
 

The critical test is the abdominal scan (usually an ultrasound scan or CT scan is performed). An ultrasound scan will show the mass/tumour in the pancreas, the dilated bile duct system above the obstruction to its drainage and may be used to perform a diagnostic biopsy via a needle.

 

CA 19-9 is a cell surface antigen, an oligosaccharide (related to a blood group antigen), and this is expressed particularly in gastrointestinal cells and cancers derived from these cells and secreted into the blood stream where it is measurable; pancreatic cancer cells seem a rich source for CA 19-9. Serum levels of CA 19-9 more than 100 U/ml are rarely found in benign disease (although they may occur in some forms of obstructive jaundice producing a conflict in diagnostic accuracy if the cancer of the pancreas presents with jaundice) and can be used to diagnose and monitor disease activity in pancreatic cancer.


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