胰腺神经内分泌癌中肿瘤标志物的水平及其在胰腺神经内分泌癌与胰腺导管腺癌鉴别中的价值。

The Levels of Tumor Markers in Pancreatic Neuroendocrine Carcinoma and Their Values in Differentiation Between Pancreatic Neuroendocrine Carcinoma and Pancreatic Ductal Adenocarcinoma.

作者信息

Zhuge Xiaoling, Guo Chuangen, Chen Yu, Feng Limin, Jia Rongfei, Zhao Ying, Sun Ke, Wang Zhongqiu, Chen Xiao

机构信息

From the Departments of Laboratory Medicine and.

Radiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou.

出版信息

Pancreas. 2018 Nov/Dec;47(10):1290-1295. doi: 10.1097/MPA.0000000000001181.

DOI:10.1097/MPA.0000000000001181

PMID:30308534

Abstract

OBJECTIVES

The levels of tumor markers in pancreatic neuroendocrine carcinoma (PNEC) are unknown, and imaging findings of PNEC and pancreatic ductal adenocarcinoma (PDAC) have overlaps. In this study, we show the tumor markers in PNEC and evaluate their values for distinguishing PNEC from PDAC.

METHODS

Thirty-three cases of PDAC and 21 cases of PNEC were retrospectively evaluated. The demographic information and clinical data were reviewed.

RESULTS

Pancreatic neuroendocrine carcinoma was usually misdiagnosed (57.1%) as PDAC based on imaging findings. Abnormal carbohydrate antigen (CA) 19-9, carcinoembryonic antigen (CEA), and α-fetoprotein (AFP) were observed in 19.0% to 28.6% of PNECs. Abnormal CA 19-9 and CA 125 levels were more common in PDAC than in PNEC (P < 0.05). Higher level of AFP was more common in PNEC than in PDAC (33.3% vs 3.0%, P < 0.05). The cutoff value of CA 19-9 for detecting PNEC was calculated as 38.5 U/mL or less with 0.788 sensitivity and 0.800 specificity. Carbohydrate antigen 19-9 (odds ratio [OR], 22.9; 95% confidence interval [CI], 2.94-179.3), AFP (OR, 0.08; 95% CI, 0.012-0.564), and CA 125 (OR, 17.4; 95% CI, 1.13-267.3) were predictors in differentiating PDAC from PNEC.

CONCLUSIONS

Carbohydrate antigen 19-9, AFP, and CA 125 have potential for distinguishing hypovascularized PNEC from PDAC.

摘要

目的

胰腺神经内分泌癌（PNEC）中肿瘤标志物的水平尚不清楚，且PNEC与胰腺导管腺癌（PDAC）的影像学表现存在重叠。在本研究中，我们展示了PNEC中的肿瘤标志物，并评估了它们在区分PNEC与PDAC方面的价值。

方法

回顾性评估33例PDAC和21例PNEC病例。查阅人口统计学信息和临床资料。

结果

基于影像学表现，胰腺神经内分泌癌通常被误诊为PDAC（57.1%）。19.0%至28.6%的PNEC病例中观察到糖类抗原（CA）19-9、癌胚抗原（CEA）和甲胎蛋白（AFP）异常。PDAC中CA 19-9和CA 125水平异常比PNEC更常见（P<0.05）。PNEC中AFP水平高于PDAC更常见（33.3%对3.0%，P<0.05）。检测PNEC的CA 19-9临界值计算为38.5 U/mL或更低，敏感性为0.788，特异性为0.800。糖类抗原19-9（优势比[OR]，22.9；95%置信区间[CI]，2.94-179.3）、AFP（OR，0.08；95%CI，0.012-0.564）和CA 125（OR，17.4；95%CI，1.13-267.3）是区分PDAC与PNEC的预测指标。