Study of serum tumor markers in the early diagnosis of pancreatic cancer.

Background: Pancreatic cancer is a highly aggressive malignancy with a dismal prognosis, primarily due to its late diagnosis. Current gold-standard diagnostic methods, such as tissue histopathological examination, are invasive and carry risks of complications (e.g., bleeding, infection, pancreatic fistula), limiting their routine use. Serum tumor markers [carbohydrate antigen 19-9 (CA-19-9), carcinoembryonic antigen (CEA)] have been widely studied for non-invasive screening, but their single use lacks sufficient sensitivity and specificity for early detection. Emerging research suggests that inflammatory and stromal-related molecules, such as soluble intercellular adhesion molecule-1 (sICAM-1) (involved in tumor cell adhesion and metastasis) and chitinase-3-like protein 1 (CHI3 L1) (a marker of tissue remodeling and inflammation), may complement traditional markers in improving diagnostic accuracy. However, their combined utility in pancreatic cancer diagnosis, particularly for differentiating early-stage tumors, remains unclear.

Aim: To explore the application value of serum tumor markers (CA-19-9, CEA) and serum sICAM-1 and CHI3 L1 in the early diagnosis of pancreatic cancer.

Methods: From October 2021 to October 2024, 51 patients with pancreatic cancer were selected for the pancreatic cancer group, and 51 healthy examinees were selected for the healthy group during the same period. The value of serum tumor markers in combination with serum sICAM-1 and CHI3 L1 for the early diagnosis of pancreatic cancer was assessed.

Results: Comparison of age, gender, body mass index, and drinking and smoking histories between the two groups was not statistically significant (P > 0.05); serum tumor marker (CA-19-9, CEA), serum sICAM-1 and CHI3 L1 levels were higher in the pancreatic cancer group (P < 0.05); pancreatic cancer patients of stage II had higher serum tumor marker (CA-19-9, CEA), serum sICAM-1, and CHI3 L1 values (P < 0.05); serum tumor markers, serum sICAM-1, and CHI3 L1 were positively correlated with pancreatic cancer (P < 0.05) and showed a positive correlation with stage I and stage II. Pancreatic cancer showed a positive correlation (P < 0.05); multifactor logistic regression analysis showed that serum tumor markers (CA-19-9, CEA), serum sICAM-1 and CHI3 L1 were independent risk factors for pancreatic cancer (P < 0.05); serum tumor markers (CA-19-9, CEA), serum sICAM-1, serum tumor marker (CA-19-9, CEA) and serum sICAM-1 and CHI3 L1 had area under the curves (AUCs) of 0.750, 0.724, 0.585, and 0.562 for pancreatic cancer diagnosis, respectively; AUCs for stage I diagnosis were 0.766, 0.752, 0.622, and 0.572 and for stage II diagnosis were 0.783, 0.758, 0.626, and 0.671, respectively, and the AUCs for the combined diagnosis of pancreatic cancer, stage I pancreatic cancer, and stage II pancreatic cancer were 0.782, 0.824, and 0.862, respectively (P < 0.05).

Conclusion: The combined detection of serum tumor markers with serum sICAM-1 and serum CHI3 L1 can significantly improve the accuracy and sensitivity of the diagnosis of pancreatic cancer and its different stages.