An integrated analysis of host- and tumor-derived markers for predicting high-grade dysplasia and associated invasive carcinoma of intraductal papillary mucinous neoplasms of the pancreas

Tatsuo Hata, Masamichi Mizuma, Fuyuhiko Motoi, Masaharu Ishida, Takanori Morikawa, Kei Nakagawa, Hiroki Hayashi, Atsushi Kanno, Atsushi Masamune, Takashi Kamei, Takeshi Naito, Toru Furukawa, Michiaki Unno

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Purpose: To clarify the usefulness of cancer-related inflammation, hypermetabolism, and subsequent host malnutrition biomarkers for predicting the histological grades of intraductal papillary mucinous neoplasms of the pancreas (IPMNs). Methods: The systemic immune-inflammation index (SII), prognostic nutritional index (PNI), and maximum standardized uptake value (SUVmax) on fluorodeoxyglucose-positron emission tomography were compared across 171 resected IPMN cases of different histological grades. The diagnostic performance of each marker and of their combinations for predicting IPMN with high-grade dysplasia (HGD)/associated invasive carcinoma (INV) was also tested. Results: Of the 171 IPMNs, the IPMN cases with HGD showed significantly higher values of SII (median 406 vs. 340; P = 0.041) and SUVmax (median 2.5 vs. 2.0; P = 0.001) than those with low-grade dysplasia (LGD). On a multivariate analysis, the SII and SUVmax were both independent markers for predicting HGD/INV. A combination analysis including the tumor- and host-derived markers in combination with imaging findings showed an improved diagnostic performance (area under the curve 0.824; sensitivity 75.9%; specificity 80.0%). Conclusions: The combination of multiple markers of host-derived inflammation and tumor-derived focal hypermetabolism can serve as a predictor for the presence of HGD/INV.

Original languageEnglish
Pages (from-to)1039-1048
Number of pages10
JournalSurgery today
Volume50
Issue number9
DOIs
Publication statusPublished - 2020 Sep 1

Keywords

  • FDG-PET
  • Intraductal papillary mucinous neoplasm of the pancreas
  • Prognostic nutritional index
  • Systemic immune-inflammation index
  • Tumor marker

ASJC Scopus subject areas

  • Surgery

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