The value of preoperative CA19-9 combined with platelet-to-lymphocyte ratio in predicting invasive malignancy in intraductal papillary mucinous neoplasms
10.3760/cma.j.issn.0529-5815.2019.03.003
- VernacularTitle: 术前CA19-9联合血小板和淋巴细胞比值预测胰腺导管内乳头状黏液性肿瘤癌变风险的价值分析
- Author:
Jian′ang LI
1
;
Xu HAN
;
Yuan FANG
;
Lei ZHANG
;
Wenhui LOU
;
Xuefeng XU
;
Wenchuan WU
;
Tiantao KUANG
;
Dansong WANG
;
Yefei RONG
Author Information
1. Department of Pancreatic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- Publication Type:Journal Article
- Keywords:
Pancreatic neoplasms;
Carcinoma, intraductal, noninfiltrating;
Invasive malignancy;
CA19-9;
Platelet-to-lymphocyte ratio
- From:
Chinese Journal of Surgery
2019;57(3):170-175
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore preoperative predictive markers for invasive malignancy in intraductal papillary mucinous neoplasm(IPMN).
Methods:The retrospective case-controlled study was adopted.Seventy-nine patients who underwent surgery and with pathologically confirmed IPMN from January 2005 to December 2014 at Department of Pancreatic Surgery, Zhongshan Hospital Fudan University were enrolled.Forty-six patients were male and 33 were female,with an average age of (62.9±8.9)years (range:37-82 years).Tumor sites:56 tumors were located at the head of the pancreas,22 were located at the body and tail of the pancreas,and 1 was located across the whole pancreas.Surgical procedures: 51 patients underwent pancreaticoduodenectomy, 22 patients underwent distal pancreatectomy, 4 patients underwent segmental pancreatectomy and 2 patients underwent total pancreatectomy.IPMNs were classified into non-invasive lesions and invasive carcinomas according to the histopathological findings of the tumor.Thirty-two tumors were non-invasive lesions and 47 were invasive carcinomas.The preoperative findings were compared between patients with non-invasive IPMN and patients with invasive carcinoma by univariate analysis using t test and χ2 test accordingly,and factors with statistically significance were subsequently submitted to multivariate analysis.
Results:Univariate analysis showed that tumor size(P=0.022), carcinoembryonic antigen(P=0.012), CA19-9(P=0.011), lymphocytes(P=0.034), neutrophil-to-lymphocyte ratio(P=0.010)and platelet-to-lymphocyte ratio(PLR)(P=0.004)were predictive markers with statistical significance.Multivariate analysis showed that CA19-9(P=0.012)and PLR(P=0.025) were independent predictive markers for invasive malignancy in IPMN.The area under curve of the combination factor of CA19-9 and PLR(0.864) was larger than that of CA19-9(0.806) or PLR(0.685) alone, and all the authentic indicators of the combination factor were better than those of each alone.
Conclusions:CA19-9 and PLR are independent predictive markers for invasive malignancy in IPMN.The combination of CA19-9 and PLR has improved efficacy than each alone.
