Home > Pancreas Education > Detection and Diagnosis > Blood Tests

Blood and Cytology Tests

Currently, there is no simple blood test that exists solely to detect or diagnose early pancreatic cancer. However, there are certain blood tests that can support a diagnosis of pancreatic cancer, or help your doctor determine treatment if evidence of cancer is found. None of these tests can be used as conclusive diagnostic tools on their own.

Hepatic Function Test

The hepatic function test will be a standard component of your blood work up and will test your bilirubin and enzyme levels. If there is a tumor blocking your bile duct, the bilirubin levels in your blood may increase and cause you to become jaundiced. The normal range of bilirubin levels is between .3mg/dL (milligrams per deciliter) and 1.3 mg/dL. Liver enzymes and pancreatic enzymes, such as amylase, may also be elevated as a result of a blocked bile duct.

CA 19-9 Tumor Marker

A tumor marker is a substance that may leak into the bloodstream and that can be produced by the tumor cell or by the body in response to the tumor cell. The levels of tumor markers in your bloodstream can help your doctor evaluate you for certain types of cancer.

CA 19-9 is a tumor marker commonly associated with pancreatic cancer. The normal range of CA 19-9 in the blood of a healthy individual is 0-37 U/mL (units/milliliter). People suffering from pancreatic cancer often have elevated levels of CA 19-9. However, it is important to note that not every patient with pancreatic cancer will have elevated levels of CA 19-9. Also, some non-cancerous conditions, like pancreatitis and jaundice, can cause high levels of CA 19-9. Therefore, CA 19-9 cannot be used as a diagnostic or screening measure on its own.

If you are diagnosed with pancreatic cancer, your physician may use changes in your CA 19-9 levels to determine if your tumor is remaining stable, progressing, or responding to treatment. Your doctor may take a baseline CA 19-9 level before surgery or before beginning a cycle of chemotherapy. If your CA 19-9 levels decrease after treatment, that typically indicates a positive response. If after several cycles of chemotherapy your CA 19-9 levels remain the same, that indicates your cancer is stable. If, however, your CA 19-9 levels rise, that can indicate either a recurrence of your cancer or that you are no longer responding to your current treatment plan.

Carcinoembryonic Antigen (CEA)

CEA is a protein that may also be used as a tumor marker. CEA is typically found in the blood of a developing fetus, but disappears almost entirely from the blood stream after birth. The normal range of CEA in an adult non-smoker is less than 2.5 ng/mL (nanograms per milliliter), and less than 5.0 ng/mL for an adult smoker. However, certain cancers like colorectal cancer and those involving the gastrointestinal tract are known to increase CEA levels in adults. CEA levels greater than 20 ng/mL before therapy are associated with metastatic cancer.

Similar to CA 19-9, CEA cannot be used as a diagnostic or screening test for pancreatic cancer because both cancerous and non-cancerous conditions can increase CEA levels. Smoking, certain infections, pancreatitis, and cirrhosis of the liver can all cause elevated CEA levels. Additionally, chemotherapy and radiation therapy can cause a temporary rise in CEA levels due to increased CEA release by tumor cells that are being destroyed.

Also similar to CA 19-9, the CEA test is best used to determine disease progression and treatment effectiveness. Your doctor may track the changes in your CEA levels throughout your treatment if you are diagnosed with pancreatic cancer.

Additionally, if a cyst is found in the pancreas, a physician may aspirate, or pull fluid out, of the cyst to relieve symptoms and perform cytology tests. CEA levels found in the fluid can help your physician reach a diagnosis. Levels above 200 are worrisome.