Comparison of tumor markers for predicting outcomes after resection of nonfunctioning pancreatic neuroendocrine tumors

作者：Cherenfant Jovenel^*; Talamonti Mark S; Hall Curtis R; Thurow Tiffany A; Gage Mistry K; Stocker Susan J; Lapin Brittany; Wang Edward; Silverstein Jonathan C; Mangold Kathy; Odeleye Melanie; Kaul Karen L; Lamzabi Ihab; Gattuso Paolo; Winchester David J; Marsh Robert W; Roggin Kevin K; Bentrem David J; Baker Marshall S; Prinz Richard A

来源：Surgery, 2014, 156(6): 1504-1511.

DOI：10.1016/j.surg.2014.08.043

Background. This study compares the predictability of 5 tumor markers for distant metastasis and mortality in pancreatic neuroendocrine tumors (PNETs). %26lt;br%26gt;Methods. A total of 128 patients who underwent pancreatectomy for nonfunctioning PNETs between 1998 and 2011 were evaluated. Tumor specimens were stained via immunochemistry for cytoplasmic and nuclear survivin, cytokeratin 19 (CK19), c-KIT and Ki67. Univariate and multivariate regression analyses and receiver operating characteristics curve were used to evaluate the predictive value of these markers. %26lt;br%26gt;Results. A total of 116 tumors (91%) were positive for cytoplasmic survivin, 95 (74%) for nuclear survivin, 85 (66.4%) for CK19, 3 for c-KIT, and 41 (32%) for Ki67 %26gt;3%. Twelve (9%) tumors expressed none of the markers. Survivin, CK19, and c-KIT had no substantial effect on distant metastasis or mortality. Age %26gt; 55 years, grade 3 histology, distant metastasis, and Ki67 %26gt;3% were associated with mortality (P %26lt; .05). A cut-off of Ki67 %26gt; 3% was the best predictor (83%) of mortality with an area under the curve of 0.85. Ki67 %26gt; 3 % also predicted occurrence of distant metastases with odds ratio of 9.22 and 95% confidence interval of 1.55-54.55 (P %26lt; .015). %26lt;br%26gt;Conclusion. Of the 5 markers studied, only Ki67 %26gt; 3% was greatly associated with distant metastasis and death. Survivin, CK19, and c-KIT had no prognostic value in nonfunctioning PNETs.

• 出版日期2014-12
• 单位西北大学