TY - JOUR
T1 - Comparison of tumor markers for predicting outcomes after resection of nonfunctioning pancreatic neuroendocrine tumors
AU - Cherenfant, Jovenel
AU - Talamonti, Mark S.
AU - Hall, Curtis R.
AU - Thurow, Tiffany A.
AU - Gage, Mistry K.
AU - Stocker, Susan J.
AU - Lapin, Brittany
AU - Wang, Edward
AU - Silverstein, Jonathan C.
AU - Mangold, Kathy
AU - Odeleye, Melanie
AU - Kaul, Karen L.
AU - Lamzabi, Ihab
AU - Gattuso, Paolo
AU - Winchester, David J.
AU - Marsh, Robert W.
AU - Roggin, Kevin K.
AU - Bentrem, David J.
AU - Baker, Marshall S.
AU - Prinz, Richard A.
N1 - Publisher Copyright:
© 2014 Elsevier Inc.
PY - 2014
Y1 - 2014
N2 - Background. This study compares the predictability of 5 tumor markers for distant metastasis and mortality in pancreatic neuroendocrine tumors (PNETs). 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. 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 >3%. Twelve (9%) tumors expressed none of the markers. Survivin, CK19, and c-KIT had no substantial effect on distant metastasis or mortality. Age >55 years, grade 3 histology, distant metastasis, and Ki67 >3% were associated with mortality (P < .05). A cut-off of Ki67 >3% was the best predictor (83%) of mortality with an area under the curve of 0.85. Ki67 >3% also predicted occurrence of distant metastases with odds ratio of 9.22 and 95% confidence interval of 1.55-54.55 (P < .015). Conclusion. Of the 5 markers studied, only Ki67 >3% was greatly associated with distant metastasis and death. Survivin, CK19, and c-KIT had no prognostic value in nonfunctioning PNETs.
AB - Background. This study compares the predictability of 5 tumor markers for distant metastasis and mortality in pancreatic neuroendocrine tumors (PNETs). 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. 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 >3%. Twelve (9%) tumors expressed none of the markers. Survivin, CK19, and c-KIT had no substantial effect on distant metastasis or mortality. Age >55 years, grade 3 histology, distant metastasis, and Ki67 >3% were associated with mortality (P < .05). A cut-off of Ki67 >3% was the best predictor (83%) of mortality with an area under the curve of 0.85. Ki67 >3% also predicted occurrence of distant metastases with odds ratio of 9.22 and 95% confidence interval of 1.55-54.55 (P < .015). Conclusion. Of the 5 markers studied, only Ki67 >3% was greatly associated with distant metastasis and death. Survivin, CK19, and c-KIT had no prognostic value in nonfunctioning PNETs.
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U2 - 10.1016/j.surg.2014.08.043
DO - 10.1016/j.surg.2014.08.043
M3 - Article
C2 - 25456943
AN - SCOPUS:84922424369
SN - 0039-6060
VL - 156
SP - 1504
EP - 1511
JO - Surgery (United States)
JF - Surgery (United States)
IS - 6
ER -