CA19-9/DBil: a promising indicator to distinguish between CA19-9-elevated pancreatic head-type autoimmune pancreatitis and pancreatic head cancer
Abstract Background Pancreatic head-type autoimmune pancreatitis (PH-AIP) with elevated CA19-9 is sometimes difficult to distinguish from pancreatic head cancer (PHC) with elevated CA19-9. At times, IgG4 proves inadequate in offering assistance. The study aimed to elucidate the performance of CA19-9...
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BMC
2025-04-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-025-03925-9 |
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| author | Wenfeng Xi Wanying Liao Tao Guo Qingwei Jiang Xiaoyin Bai Xi Wu Yunlu Feng Shengyu Zhang Dongsheng Wu Qiang Wang Aiming Yang |
| author_facet | Wenfeng Xi Wanying Liao Tao Guo Qingwei Jiang Xiaoyin Bai Xi Wu Yunlu Feng Shengyu Zhang Dongsheng Wu Qiang Wang Aiming Yang |
| author_sort | Wenfeng Xi |
| collection | DOAJ |
| description | Abstract Background Pancreatic head-type autoimmune pancreatitis (PH-AIP) with elevated CA19-9 is sometimes difficult to distinguish from pancreatic head cancer (PHC) with elevated CA19-9. At times, IgG4 proves inadequate in offering assistance. The study aimed to elucidate the performance of CA19-9/DBil in distinguishing between the two conditions. Methods This was a retrospective study. We collected serologic indicators from participants in PH-AIP and PHC Group. Three logistic regression equations were established ranging from non-adjustment (Model 1, only CA19-9/DBil included) to adjusting for sex, age, and CEA (Model 2 and Model 3) to explore the relationship between CA19-9/DBil and PH-AIP probability. ROC, Decision Curve Analysis (DCA), calibration curve were conducted. P for AUCs and net reclassification improvements (NRI) were computed to evaluate differences in discrimination and the improvement in risk reclassification between models. Results The study included 90 PHC and 35 PH-AIP patients, all with elevated CA19-9. The ORs for CA19-9/DBil in three models were similar (0.915 to 0.921). ROC revealed that Model 1 had an AUC of 0.772. The sensitivity, specificity, and accuracy at the best threshold were all > 0.7. Model 1, although simple, was not inferior in its discriminative ability compared to complex models: the difference in discrimination between Model 1 and each of two adjusted models was not statistically significant (P > 0.05, both AUC and NRI). Additionally, calibration curve and DCA suggested that Model 1 had good calibration and clinical utility. Conclusions CA19-9/DBil exhibited promising diagnostic performance in differentiating between CA19-9-elevated PH-AIP and PHC. |
| format | Article |
| id | doaj-art-dcd13b423ca346d7bd1145639d00cac2 |
| institution | Kabale University |
| issn | 1471-230X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj-art-dcd13b423ca346d7bd1145639d00cac22025-08-20T03:52:20ZengBMCBMC Gastroenterology1471-230X2025-04-012511810.1186/s12876-025-03925-9CA19-9/DBil: a promising indicator to distinguish between CA19-9-elevated pancreatic head-type autoimmune pancreatitis and pancreatic head cancerWenfeng Xi0Wanying Liao1Tao Guo2Qingwei Jiang3Xiaoyin Bai4Xi Wu5Yunlu Feng6Shengyu Zhang7Dongsheng Wu8Qiang Wang9Aiming Yang10Department of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Gastroenterology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesAbstract Background Pancreatic head-type autoimmune pancreatitis (PH-AIP) with elevated CA19-9 is sometimes difficult to distinguish from pancreatic head cancer (PHC) with elevated CA19-9. At times, IgG4 proves inadequate in offering assistance. The study aimed to elucidate the performance of CA19-9/DBil in distinguishing between the two conditions. Methods This was a retrospective study. We collected serologic indicators from participants in PH-AIP and PHC Group. Three logistic regression equations were established ranging from non-adjustment (Model 1, only CA19-9/DBil included) to adjusting for sex, age, and CEA (Model 2 and Model 3) to explore the relationship between CA19-9/DBil and PH-AIP probability. ROC, Decision Curve Analysis (DCA), calibration curve were conducted. P for AUCs and net reclassification improvements (NRI) were computed to evaluate differences in discrimination and the improvement in risk reclassification between models. Results The study included 90 PHC and 35 PH-AIP patients, all with elevated CA19-9. The ORs for CA19-9/DBil in three models were similar (0.915 to 0.921). ROC revealed that Model 1 had an AUC of 0.772. The sensitivity, specificity, and accuracy at the best threshold were all > 0.7. Model 1, although simple, was not inferior in its discriminative ability compared to complex models: the difference in discrimination between Model 1 and each of two adjusted models was not statistically significant (P > 0.05, both AUC and NRI). Additionally, calibration curve and DCA suggested that Model 1 had good calibration and clinical utility. Conclusions CA19-9/DBil exhibited promising diagnostic performance in differentiating between CA19-9-elevated PH-AIP and PHC.https://doi.org/10.1186/s12876-025-03925-9Autoimmune pancreatitisPancreatic cancerDifferential diagnosis |
| spellingShingle | Wenfeng Xi Wanying Liao Tao Guo Qingwei Jiang Xiaoyin Bai Xi Wu Yunlu Feng Shengyu Zhang Dongsheng Wu Qiang Wang Aiming Yang CA19-9/DBil: a promising indicator to distinguish between CA19-9-elevated pancreatic head-type autoimmune pancreatitis and pancreatic head cancer BMC Gastroenterology Autoimmune pancreatitis Pancreatic cancer Differential diagnosis |
| title | CA19-9/DBil: a promising indicator to distinguish between CA19-9-elevated pancreatic head-type autoimmune pancreatitis and pancreatic head cancer |
| title_full | CA19-9/DBil: a promising indicator to distinguish between CA19-9-elevated pancreatic head-type autoimmune pancreatitis and pancreatic head cancer |
| title_fullStr | CA19-9/DBil: a promising indicator to distinguish between CA19-9-elevated pancreatic head-type autoimmune pancreatitis and pancreatic head cancer |
| title_full_unstemmed | CA19-9/DBil: a promising indicator to distinguish between CA19-9-elevated pancreatic head-type autoimmune pancreatitis and pancreatic head cancer |
| title_short | CA19-9/DBil: a promising indicator to distinguish between CA19-9-elevated pancreatic head-type autoimmune pancreatitis and pancreatic head cancer |
| title_sort | ca19 9 dbil a promising indicator to distinguish between ca19 9 elevated pancreatic head type autoimmune pancreatitis and pancreatic head cancer |
| topic | Autoimmune pancreatitis Pancreatic cancer Differential diagnosis |
| url | https://doi.org/10.1186/s12876-025-03925-9 |
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