Erschienen in:
27.07.2018 | Pancreatic Tumors
Serum Elastase 1 Level as a Risk Factor for Postoperative Recurrence in Patients with Well-Differentiated Pancreatic Neuroendocrine Neoplasms
verfasst von:
Yoshihide Nanno, MD, PhD, Hirochika Toyama, MD, PhD, Yoh Zen, MD, PhD, FRCPath, Masayuki Akita, MD, Yasuhisa Ando, MD, Takuya Mizumoto, MD, Yuki Ueda, MD, Tetsuo Ajiki, MD, PhD, Keiichi Okano, MD, PhD, Yasuyuki Suzuki, MD, PhD, Takumi Fukumoto, MD, PhD
Erschienen in:
Annals of Surgical Oncology
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Ausgabe 11/2018
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Abstract
Purpose
This study was designed to assess the potential role of the preoperative serum level of elastase 1 as a risk factor for recurrence in patients with resectable well-differentiated pancreatic neuroendocrine neoplasms (PanNETs).
Methods
Preoperative serum elastase 1 levels were measured in 53 patients with PanNETs who underwent complete tumor resection in two tertiary referral centers between January 2004 and June 2017. The preoperative elastase 1 levels were correlated with clinicopathological characteristics, including tumor recurrence and recurrence-free survival.
Results
The median elastase 1 level was 96 ng/dL (range: 21–990 ng/dL). Preoperative serum elastase 1 levels were significantly higher in those with tumors ≥ 20 mm in diameter (vs. < 20 mm, P = 0.018), WHO grade 2 (vs. grade 1, P = 0.035), and microscopic venous invasion (vs. without venous invasion, P = 0.039). The median preoperative serum level of elastase 1 was higher in patients with recurrence than in those without recurrence (251 vs. 80 ng/dL, P = 0.004). Receiver operating characteristic analysis of elastase 1 levels showed that a cutoff level of 250 ng/dL was associated with postoperative recurrence, with 63% sensitivity, 100% specificity, and 94% overall accuracy. Patients with higher elastase 1 levels showed significantly worse recurrence-free survival than that of those with lower levels (2-year recurrence-free survival rate: 25% and 92%, respectively, P < 0.001).
Conclusions
Our data provide the first evidence that high preoperative elastase 1 levels may be a risk factor for postoperative recurrence in patients with resectable PanNETs.