Tissue polypeptide specific antigen (TPS), a marker for differentiation between pancreatic carcinoma and chronic pancreatitis. A comparative study with CA 19-9

Cancer. 2000 Jul 1;89(1):83-8. doi: 10.1002/1097-0142(20000701)89:1<83::aid-cncr12>3.0.co;2-j.


Background: The value of serum tissue polypeptide specific antigen (TPS) as a complement to CA 19-9 in the detection of pancreatic carcinoma was determined prospectively. TPS and CA 19-9 levels obtained at the time of diagnosis in patients suspected of having chronic pancreatitis or pancreatic carcinoma were evaluated in receiver operating characteristic (ROC) curve analysis.

Methods: Serum TPS and CA 19-9 levels were measured by immunoassays in 122 subjects, 48 with pancreatic carcinoma and 74 with chronic pancreatitis.

Results: Elevated levels of CA 19-9 were detected preoperatively in 70% of pancreatic carcinoma patients and in 19% of chronic pancreatitis patients. Elevated levels of TPS were detected in 100% of patients with pancreatic carcinoma and in 22% of patients with chronic pancreatitis. The median levels of TPS and CA 19-9 for pancreatic carcinoma were significantly higher than those for chronic pancreatitis (P < 0.0001). Increasing the upper reference value of TPS allowed for better discrimination between chronic pancreatitis and pancreatic carcinoma. ROC curve analysis showed that the introduction of 200 U/L as a decision criterion for TPS did not reduce its sensitivity but significantly improved its specificity. At a specificity of 98% for TPS, discrimination between pancreatic carcinoma and chronic pancreatitis was found to be 97%. Increasing the upper reference level for CA 19-9 to attain a specificity of 98% decreased its sensitivity from 70% to 33%.

Conclusions: At an elevated cut-off level for TPS (200 U/L), almost complete discrimination between pancreatic carcinoma and chronic pancreatitis was obtained. TPS will be more useful than CA 19-9 in the differential diagnosis of pancreatic carcinoma and chronic pancreatitis.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / analysis*
  • CA-19-9 Antigen / analysis*
  • Carcinoma / diagnosis*
  • Carcinoma / immunology
  • Chronic Disease
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunoassay
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / immunology
  • Pancreatitis / diagnosis*
  • Pancreatitis / immunology
  • Prospective Studies
  • Sensitivity and Specificity
  • Tissue Polypeptide Antigen / analysis*


  • Biomarkers, Tumor
  • CA-19-9 Antigen
  • Tissue Polypeptide Antigen