Utilizzazione dell'anticorpo monoclinale Dupan 2 nella diagnosi di carcinoma pancreatico

We performed a preliminary study to evaluate the potential usefulness of Dupan 2 compared with CA19-9 and CEA in improving early diagnosis of pancreatic tumor. Eighty-nine patients were included: 30 normal volunteers (NV), 30 patients with pancreatric tumor (PT) and 29 with chronic pancreatitis (CP). Dosage of Dupan 2 antigen levels was performed by a sandwich enzyme immunoassay kit (Kyowa Medex Co. Ltd) using the Dupan 2 monoclonal antibody reported by Metzgar in 1982. Mean serum levels were: 21.9±41.9 U/ml (95% CI from 6.8 to 37.2) in NV group, 1521.3±2212.5 U/ml (95% CI from 717.4 to 2325.1) in PT group and 498.3±994.1 U/ml (95% CI from 130.9 to 865.6) in CP group. Though the analysis of variance showed a signigicant difference between the 3 groups (p=0.0003), the wide dispersion of values in PT and CP groups, as shown by the confidence intervals, does not seem to garantee a clinical value to this statistical difference. Therefor, the Dupan 2 serum antigen levels were not helpful in this work in distinguishing patients with pancreatic tumor from those with chronic pancreatitis. This finding was also confirmed by the mild specificity of test (61%, in spite of a high sensibility (83%). Finally Dupan 2 showed no correlation (Pearson's test) with CA 19-9 (r=0.2331) and CEA (r=0.1130) in PT group. In conclusion, this preliminary study showed that Dupan 2 serum assay is a highly sensitive test; but it does not improve the results obtained with CA 19-9. It is necessary to recruit further patients to confirm these data and to recommend the routinary use of Dupan 2 serum assay in the diagnosis of pancreatic cancer.