Clinical implication of serum carcinoembryonic antigen and carbohydrate antigen 19‐9 for the prediction of malignancy in intraductal papillary mucinous neoplasm of pancreas. (14th July 2015)

• Record Type: Journal Article
• Authors: Kim, Jae Ri; Jang, Jin‐Young; Kang, Mee Joo; Park, Taesung; Lee, Seung Yeoun; Jung, Woohyun; Chang, Jihoon; Shin, Youngchan; Han, Youngmin; Kim, Sun‐Whe
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 22:Number 9(2015)
• Page Start: 699
• Page End: 707
• Publication Date: 2015-07-14
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.275
• Languages: English
• ISSNs: 1868-6974

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jhbp275-sec-0001" sec-type="section"> <title>Background</title> <p>Little is known about the prognostic significance of serum carbohydrate antigen (CA) 19‐9 and carcinoembryonic antigen (CEA) concentrations for predicting malignancy in patients with intraductal papillary mucinous neoplasm (IPMN) of pancreas.</p> </sec> <sec id="jhbp275-sec-0002" sec-type="section"> <title>Method</title> <p>The study cohort consisted of 367 patients with surgical biopsy proven IPMN at Seoul National University Hospital. Preoperative serum tumor markers were evaluated and compared with other clinical variables.</p> </sec> <sec id="jhbp275-sec-0003" sec-type="section"> <title>Results</title> <p>Malignant pathology (high grade dysplasia [HGD] and invasive IPMN) was identified in 117 (31.9%) patients. Elevated serum CA19‐9 was more frequent in patients with malignant (34.2%, <italic>P</italic> < 0.001; invasive IPMN vs. HGD 47.9% vs. 11.4%, <italic>P</italic> < 0.001) and main duct type (40.0%, <italic>P</italic> = 0.003) IPMN. Multivariate analysis showed main pancreatic duct (MPD) >5 mm (<italic>P</italic> < 0.001), mural nodules (<italic>P</italic> < 0.001), and elevated serum CA19‐9 (<italic>P</italic> < 0.001) were independent predictors of malignancy. The sensitivity, specificity and accuracy were 34.2%, 92.4%, and 73.8%, respectively, for elevated serum CA19‐9; 63.3%, 78.0%, and 73.3%, for MPD >5 mm; and 59.0%, 86.4%, and 77.7%, for mural nodules.</p> </sec> <sec id="jhbp275-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Serum CA19‐9 is significantly higher in patients with malignant IPMN, especially in patients with invasive and main duct type IPMN. The diagnostic power of serum CA19‐9 in predicting malignancy is comparable to that of MPD >5 mm and mural nodules.</p> </sec> </abstract>