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Clinical implication of serum carcinoembryonic antigen and carbohydrate antigen 19‐9 for the prediction of malignancy in intraductal papillary mucinous neoplasm of pancreas
Author(s) -
Kim Jae Ri,
Jang JinYoung,
Kang Mee Joo,
Park Taesung,
Lee Seung Yeoun,
Jung Woohyun,
Chang Jihoon,
Shin Youngchan,
Han Youngmin,
Kim SunWhe
Publication year - 2015
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.275
Subject(s) - intraductal papillary mucinous neoplasm , medicine , carcinoembryonic antigen , malignancy , gastroenterology , pancreas , ca19 9 , pancreatic duct , pathology , cancer , pancreatic cancer
Background 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. Method 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. Results 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%, P < 0.001; invasive IPMN vs. HGD 47.9% vs. 11.4%, P < 0.001) and main duct type (40.0%, P = 0.003) IPMN. Multivariate analysis showed main pancreatic duct (MPD) >5 mm ( P < 0.001), mural nodules ( P < 0.001), and elevated serum CA19‐9 ( P < 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. Conclusion 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.