title: The predictive value of mean platelet volume in differential diagnosis of non-functional pancreatic neuroendocrine tumors from pancreatic adenocarcinomas.
abstract: OBJECTIVE
  The aim of the present study is to evaluate in a retrospective manner the diagnostic value of mean platelet volume (MPV) in pancreatic adenocarcinomas and pancreatic neuroendocrine tumors (PNETs).
  
  
  METHODS
  A total of 92 patients, who were admitted for pancreatic adenocarcinoma (n=76) and PNET (n=16) between March 2007 and December 2009, were analyzed retrospectively for demographics and clinical information.
  
  
  RESULTS
  Thirty-nine patients (51.3%) had a resectable, whereas 37 patients (48.7%) had an unresectable pancreatic adenocarcinoma. Nine patients (56.3%) had a non-functional PNET, 6 patients (37.5%) had an insulinoma, and the remaining one patient had a gastrinoma. The mean age was 59.3±10.5 for pancreatic adenocarcinomas and 45.1±10.6 for PNETs. The mean age at diagnosis was significantly higher in patients with pancreatic adenocarcinomas than the patients with PNET (p<0.001). Preoperative mean hemoglobin levels were significantly lower in patients with pancreatic adenocarcinoma than those with PNET (12.4±1.8g/dl vs 13.7±2.2g/dl), (p<0.013). The preoperative median MPV levels were significantly lower in patients with PNET 7.8fL (7.2-9.4) than in patients with pancreatic adenocarcinomas 8.6fL (6.6-13.5), (p<0.014). In subgroup analysis, a significant difference in MPV levels was mainly caused by the difference between pancreatic adenocarcinomas and non-functional PNETs (p=0.017). The cut-off value of MPV level for detection of PNETs was calculated as≤7.8fL using ROC analysis [Sensitivity: 66.7%, specificity: 75.9%, AUC: 0.734 (0.587-0.880) p=0.022]. In logistic regression analysis, independent predictive factors for determining PNETs in the differential diagnosis of pancreatic adenocarcinomas were calculated as age (OR=0.068, 95% CI: 0.012-0.398), Ca 19-9 (OR=0.039, 95% CI: 0.006-0.263), MPV (OR=0.595, 95% CI: 0.243-1.458), and hemoglobin (OR=1.317, 95% CI: 0.831-2.086).
  
  
  CONCLUSIONS
  Age, Ca 19-9, MPV, and hemoglobin levels have diagnostic value for distinguishing PNETs from pancreatic adenocarcinomas.
authors.affiliation: Department of Gastroenterological Surgery, Turkiye Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Kerem
authors.initials: K
authors.lastname: Karaman
authors.forename: Erdal Birol
authors.initials: EB
authors.lastname: Bostanci
authors.forename: Erol
authors.initials: E
authors.lastname: Aksoy
authors.forename: Mevlut
authors.initials: M
authors.lastname: Kurt
authors.forename: Bahadır
authors.initials: B
authors.lastname: Celep
authors.forename: Murat
authors.initials: M
authors.lastname: Ulas
authors.forename: Tahsin
authors.initials: T
authors.lastname: Dalgic
authors.forename: Ali
authors.initials: A
authors.lastname: Surmelioglu
authors.forename: Mutlu
authors.initials: M
authors.lastname: Hayran
authors.forename: Musa
authors.initials: M
authors.lastname: Akoglu
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D001792:Blood Platelets / Q000473:pathology*; D018395:CA-19-9 Antigen / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006403:Hematologic Tests / Q000379:methods; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000097:blood* / Q000175:diagnosis*; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D018395:CA-19-9 Antigen; D006454:Hemoglobins