There are no established laboratory tests for the early detection or diagnosis of pancreatic cancer. Diagnosis is usually made by imaging tests and a tissue biopsy, and most cancers have already metastasized by this time.
Some imaging tests that may be used to detect pancreatic cancer include:
- Computed tomography (CT) scan: useful for detecting pancreatic masses and checking for metastasized cancer
- Endoscopic retrograde cholangiopancreatography (ERCP): a flexible scope is inserted into the pancreatic duct and a dye is injected. X-rays can then reveal abnormalities in the structure of the pancreas due to the presence of a tumor. If abnormal areas are identified, a biopsy can be performed.
- Magnetic resonance cholangiopancreatography (MRCP): a type of magnetic resonance imaging (MRI) used to see the pancreas, its ducts, and the bile ducts more clearly; often used before or instead of ERCP because it is faster and noninvasive; also useful in distinguishing pancreatitis from pancreatic cancer
For more information on imaging studies, see RadiologyInfo.org.
Laboratory tests that may show abnormal results but are not diagnostic of pancreatic cancer include the following:
- Comprehensive metabolic panel: a group of tests that may be used to evaluate liver and kidney function and to determine why someone is jaundiced
- CA 19-9 (Cancer antigen 19-9): a tumor marker for pancreatic cancer; it may be used to distinguish pancreatic cancer from other cancers or to monitor for cancer recurrence. It is not currently useful for detection or diagnosis by itself because non-cancerous conditions can cause elevated CA 19-9 levels. Recent research, however, suggests that it may be useful for early detection of pancreatic cancer when combined with a promising new microRNA-detecting test that is still under investigation.
- CEA (Carcinoembryonic antigen): a tumor marker used as a monitoring tool
- Amylase: blood level may be elevated
- Other tests, such as fecal fat, stool trypsin, serum trypsinogen, and lipase, may be ordered to help evaluate how well the pancreas is functioning and to determine whether pancreatic enzyme supplementation is necessary.
A biopsy may be used to confirm a diagnosis of cancer through examination of pancreatic tissue.