Serum and pancreatic juice carcinoembryonic antigen (CEA) concentrations were studied in a group of 144 patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) with a variety of benign and malignant pancreatic and biliary diseases. Serum CEA was found to be a poor diagnostic and discriminating marker for pancreatic disorders and was raised in obstructive jaundice from various causes correlating with serum alkaline phosphatase. A pancreatic juice CEA concentration of greater than 106 mcg/l was associated with pancreatic disease but did not distinguish benign from malignant lesions. Criteria derived from pancreatic juice volumes and bicarbonate responses provided additional diagnostic differentiation of normal from pancreatic disease but not cancer from pancreatitis. Pancreatic juice CEA may have a limited application where imaging techniques have failed or are not available and additional study of pancreatic juice biochemistry is required before adequate diagnostic criteria can be established.
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