title: Emerging role of tumor markers and biochemistry in the preoperative invasive assessment of intraductal papillary mucinous neoplasm of the pancreas.
abstract: BACKGROUND
  We explored the significance of laboratory examinations in predicting invasive carcinoma derived from intraductal papillary mucinous neoplasm (IPMN).
  
  
  METHODS
  We retrospectively reviewed preoperative laboratory examination data and postoperative pathological data for 87 patients with IPMN who underwent surgical resection at Peking Union Medical College Hospital from February 2008 to March 2015.
  
  
  RESULTS
  Histological review of 87 patients with surgical resection revealed 4 cases of mild-grade dysplasia (4.6%), 34 cases of intermediate dysplasia (39.1%), 16 cases of high-grade dysplasia (18.4%) and 33 cases of invasive carcinoma (37.9%). The first 3 grades were considered noninvasive. In univariate analyses, increased serum concentrations of CA19-9 (p<0.001), CA24-2 (p<0.001), CEA (p<0.001) and hsCRP (p=0.027) were significantly associated with invasive carcinoma. Multivariate analysis showed that increased serum concentrations of CA19-9 (p=0.009) and CEA (p=0.042) were significant independent predictors of invasiveness. The combination of CA19-9, CA 24-2 and CEA improved the accuracy of prediction, and the sensitivity and specificity were 71.0% and 87.7% respectively.
  
  
  CONCLUSIONS
  The development of diagnostic laboratory tests has important implications for pre-operative IPMN evaluation. Increased serum CA19-9 and CEA concentrations are independent predictors of invasive carcinoma derived from IPMN, and increased serum CA24-2 and hsCRP concentrations are significantly associated with the risk of invasiveness. Combined detection of CA19-9+CA24-2+CEA proved to be the most accurate in predicting the invasiveness of IPMN.
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
authors.forename: L
authors.initials: L
authors.lastname: You
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
authors.forename: L
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
authors.forename: W J
authors.initials: WJ
authors.lastname: Zhao
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China. Electronic address: zhao8028@263.net.
authors.forename: Y P
authors.initials: YP
authors.lastname: Zhao
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
authors.forename: M H
authors.initials: MH
authors.lastname: Dai
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D001774:Blood Chemical Analysis; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood* / Q000175:diagnosis / Q000601:surgery; D002291:Carcinoma, Papillary / Q000097:blood* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000601:surgery; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor
keywords: IPMN; Invasive; Tumor markers; hsCRP