Characteristic behavior of serum elastase 1 in pancreatic cancer.

Diagnostic significance of serum immunoreactive elastase 1 (IRE) in pancreatic cancer was evaluated in 53 patients with pancreatic cancer. Frequency of abnormally high serum IRE levels in pancreatic cancer was 66.0%; 87.0% in head cancer (N = 23), 55.0% in body & tail cancer (N = 20) and 40% in diffuse cancer (N = 10). Serum IRE level in resectable cancer was significantly higher than that in unresectable cancer. Comparative studies of serum pancreatic enzymes revealed that serum IRE was the most sensitive marker for diagnosis of pancreatic cancer. The characteristic behavior of serum IRE throughout the course of pancreatic cancer was that abnormally high levels of IRE are maintained for a longer period of time when compared to that of pancreatitis. In the comparative study of serum IRE and CA19-9, of the 9 cases of pancreatic cancer with CA19-9 levels less than 100U/ml, 7 showed abnormally high values of IRE, and of these 4 were resectable. These results indicate that in order to detect early pancreatic cancer, any elevation of serum IRE before CA19-9 increase should be noted with care, and patients who particularly show elevated IRE values for more than one month should be subjected to more extensive morphological examinations.