Division of Pancreatic Surgery, Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, China.
Division of Pancreatic Surgery, Department of General Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, China.
Pancreatology. 2023 Mar;23(2):204-212. doi: 10.1016/j.pan.2023.01.009. Epub 2023 Jan 18.
High-grade gastro-enteropancreatic neuroendocrine neoplasms (GEP-NENs) are a heterogeneous group of rare tumors of two different types: well differentiated neuroendocrine tumors grade 3 (NETs G3) and poorly differentiated neuroendocrine carcinomas (NECs). This study aimed to explore the value of eight common preoperative markers in differentiating NETs G3 from NECs and the prognosis prediction of high-grade GEP-NENs.
Seventy-two patients diagnosed with high-grade GEP-NENs who underwent surgery at our institution were recruited for this study. Demographic and clinicopathological characteristics, preoperative serum tumor markers, and survival data were collected and analyzed. Kaplan-Meier methods were used to analyze survival rates, and a Cox regression model was used to perform multivariate analyses.
Serum carcinoembryonic antigen (CEA) was dramatically higher in NECs than in NETs G3 (P = 0.025). After follow-up, 57 of the 72 patients remained for survival analysis. Elevated serum carbohydrate antigen 19-9 (CA19-9), CEA, cancer antigen 125 and sialic acid (SA) levels indicated poorer survival of high-grade GEP-NEN patients. Only CA19-9 (HR: 6.901, 95% CI: 1.843 to 25.837, P = 0.004) was regarded as an independent risk factor for overall survival. Serum CA19-9 (HR: 4.689, 95% CI: 1.127 to 19.506, P = 0.034) was also regarded as an independent factor for overall survival in NECs.
Serum CEA levels can be used to distinguish NETs G3 from NECs. Preoperative CA19-9, CEA, cancer antigen 125 and SA levels have predictive value in the prognosis of high-grade GEP-NENs. Preoperative CA19-9, neuron-specific enolase, and SA levels can predict the prognosis of NECs.
高分级胃肠胰神经内分泌肿瘤（GEP-NENs）是两种不同类型的罕见肿瘤的异质性群体：分化良好的神经内分泌肿瘤 3 级（NETs G3）和分化差的神经内分泌癌（NECs）。本研究旨在探讨 8 种常见术前标志物在区分 NETs G3 和 NECs 中的价值，以及高分级 GEP-NENs 的预后预测。
本研究纳入了在我院接受手术治疗的 72 例高分级 GEP-NENs 患者。收集并分析了患者的人口统计学和临床病理学特征、术前血清肿瘤标志物和生存数据。采用 Kaplan-Meier 方法分析生存率，采用 Cox 回归模型进行多变量分析。
NETs G3 患者的血清癌胚抗原（CEA）水平明显高于 NECs（P=0.025）。随访后，72 例患者中有 57 例进行了生存分析。升高的血清糖类抗原 19-9（CA19-9）、CEA、癌抗原 125 和唾液酸（SA）水平提示高分级 GEP-NEN 患者的生存较差。只有 CA19-9（HR：6.901，95%CI：1.843 至 25.837，P=0.004）被认为是总生存的独立危险因素。血清 CA19-9（HR：4.689，95%CI：1.127 至 19.506，P=0.034）也被认为是 NEC 患者总生存的独立因素。
血清 CEA 水平可用于区分 NETs G3 和 NECs。术前 CA19-9、CEA、癌抗原 125 和 SA 水平对高分级 GEP-NENs 的预后有预测价值。术前 CA19-9、神经元特异性烯醇化酶和 SA 水平可预测 NEC 的预后。
