Evaluating the role of serum elastase 1 in the diagnosis of pancreatic cancer

OBJECTIVE:  To determine the normal value of serum elastase 1 in Chinese adults and evaluate its diagnostic value for pancreatic cancer. METHODS:  Serum elastase 1 and CA19-9 were measured in 132 samples, including 39 patients with pancreatic cancer, 48 with other gastrointestinal malignancy, 24 with gastrointestinal benign disease and 21 healthy adults as normal control. Multiple statistical methods including receiver operating characteristics curve and discriminant analysis were employed. RESULTS:  The established normal range of serum elastase 1 in Chinese adults was found to be under 4.36 mg/L. Serum elastase 1 increased markedly in patients with pancreatic carcinoma of smaller size and/or located in the pancreatic head. The sensitivity, specificity and overall accuracy of elastase 1 for diagnosis of pancreatic cancer were 61.5%, 75.3% and 71.2%, respectively, as compared with 71.8%, 73.1% and 72.7% for CA19-9. Discriminant analysis can improve the sensitivity and overall accuracy of elastase 1 to 82.0% and 74.2%, respectively, with a slight decline in the specificity to 71.0%. CONCLUSIONS:  The cutoff value of serum elastase 1 in normal Chinese adults is 4.36 mg/L. Serum elastase 1 is effective in the diagnosis of pancreatic cancer, especially for those of smaller size or in the pancreatic head. Use of appropriate statistical methods can help to make the diagnosis more accurate.