Department of Gastroenterological Surgery, Turkiye Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey.
Eur J Intern Med. 2011 Dec;22(6):e95-8. doi: 10.1016/j.ejim.2011.04.005. Epub 2011 Jun 12.
The aim of the present study is to evaluate in a retrospective manner the diagnostic value of mean platelet volume (MPV) in pancreatic adenocarcinomas and pancreatic neuroendocrine tumors (PNETs).
A total of 92 patients, who were admitted for pancreatic adenocarcinoma (n=76) and PNET (n=16) between March 2007 and December 2009, were analyzed retrospectively for demographics and clinical information.
Thirty-nine patients (51.3%) had a resectable, whereas 37 patients (48.7%) had an unresectable pancreatic adenocarcinoma. Nine patients (56.3%) had a non-functional PNET, 6 patients (37.5%) had an insulinoma, and the remaining one patient had a gastrinoma. The mean age was 59.3±10.5 for pancreatic adenocarcinomas and 45.1±10.6 for PNETs. The mean age at diagnosis was significantly higher in patients with pancreatic adenocarcinomas than the patients with PNET (p<0.001). Preoperative mean hemoglobin levels were significantly lower in patients with pancreatic adenocarcinoma than those with PNET (12.4±1.8g/dl vs 13.7±2.2g/dl), (p<0.013). The preoperative median MPV levels were significantly lower in patients with PNET 7.8fL (7.2-9.4) than in patients with pancreatic adenocarcinomas 8.6fL (6.6-13.5), (p<0.014). In subgroup analysis, a significant difference in MPV levels was mainly caused by the difference between pancreatic adenocarcinomas and non-functional PNETs (p=0.017). The cut-off value of MPV level for detection of PNETs was calculated as≤7.8fL using ROC analysis [Sensitivity: 66.7%, specificity: 75.9%, AUC: 0.734 (0.587-0.880) p=0.022]. In logistic regression analysis, independent predictive factors for determining PNETs in the differential diagnosis of pancreatic adenocarcinomas were calculated as age (OR=0.068, 95% CI: 0.012-0.398), Ca 19-9 (OR=0.039, 95% CI: 0.006-0.263), MPV (OR=0.595, 95% CI: 0.243-1.458), and hemoglobin (OR=1.317, 95% CI: 0.831-2.086).
Age, Ca 19-9, MPV, and hemoglobin levels have diagnostic value for distinguishing PNETs from pancreatic adenocarcinomas.
本研究旨在回顾性评估平均血小板体积（MPV）在胰腺腺癌和胰腺神经内分泌肿瘤（PNET）中的诊断价值。
分析 2007 年 3 月至 2009 年 12 月期间因胰腺腺癌（n=76）和 PNET（n=16）入院的 92 例患者的人口统计学和临床资料。
39 例（51.3%）患者可进行根治性手术，37 例（48.7%）患者为不可切除性胰腺腺癌。9 例（56.3%）患者为无功能性 PNET，6 例（37.5%）患者为胰岛素瘤，其余 1 例为胃泌素瘤。胰腺腺癌患者的平均年龄为 59.3±10.5 岁，PNET 患者的平均年龄为 45.1±10.6 岁。胰腺腺癌患者的诊断年龄显著高于 PNET 患者（p<0.001）。胰腺腺癌患者术前平均血红蛋白水平显著低于 PNET 患者（12.4±1.8g/dl 比 13.7±2.2g/dl），（p<0.013）。PNET 患者术前中位数 MPV 水平为 7.8fL（7.2-9.4），明显低于胰腺腺癌患者的 8.6fL（6.6-13.5），（p<0.014）。亚组分析显示，MPV 水平的差异主要是由胰腺腺癌和无功能性 PNET 之间的差异引起的（p=0.017）。使用 ROC 分析计算 MPV 水平用于检测 PNET 的截断值为≤7.8fL [灵敏度：66.7%，特异性：75.9%，AUC：0.734（0.587-0.880），p=0.022]。在逻辑回归分析中，计算出年龄（OR=0.068，95%CI：0.012-0.398）、CA19-9（OR=0.039，95%CI：0.006-0.263）、MPV（OR=0.595，95%CI：0.243-1.458）和血红蛋白（OR=1.317，95%CI：0.831-2.086）是胰腺腺癌鉴别诊断中确定 PNET 的独立预测因素。
年龄、CA19-9、MPV 和血红蛋白水平对鉴别胰腺腺癌和 PNET 具有诊断价值。
