Analyzing the high frequency of false-positive carcinoembryonic antigen elevations in postoperative pancreatic ductal adenocarcinoma.

IF 2.1 3区医学 Q2 SURGERY Langenbeck's Archives of Surgery Pub Date : 2024-12-14 DOI:10.1007/s00423-024-03577-5

Haruka Tanaka, Yoshihiro Mise, Atsushi Takahashi, Fumihiro Kawano, Yoshinori Takeda, Hiroshi Imamura, Hirofumi Ichida, Ryuji Yoshioka, Akio Saiura

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Abstract

Purpose: The dynamics of postoperative carcinoembryonic antigen (CEA) in pancreatic ductal adenocarcinoma (PDAC) patients have not been well assessed. This study investigated the correlation between postoperative CEA elevations and tumor recurrence.

Methods: Medical records were retrospectively analyzed for 84 patients who received curative resection for PDAC from January 2019 to December 2020. Postoperative CEA levels were monitored for a minimum of 12 months. False-positive CEA elevation was defined as a CEA level exceeding 5 ng/mL without evidence of recurrence in imaging studies.

Results: Of the examined patients, 59 (70%) exhibited CEA > 5 ng/mL within the observation period. The sensitivity and specificity of elevated CEA levels for detecting recurrence were 84% and 41%, respectively. CEA elevations without tumor recurrence were observed in 27 patients, indicating a false-positive rate of 59%. More than half of these patients demonstrated peak CEA levels between 5 and 10 ng/mL, while only true-positive patients exhibited CEA levels exceeding 40.0 ng/mL.

Conclusion: CEA may rise in more than half of postoperative PDAC patients without recurrence. CEA alone is not a robust postoperative marker.

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目的：胰腺导管腺癌（PDAC）患者术后癌胚抗原（CEA）的动态变化尚未得到很好的评估。本研究调查了术后 CEA 升高与肿瘤复发之间的相关性：回顾性分析了 2019 年 1 月至 2020 年 12 月期间接受根治性切除术的 84 例 PDAC 患者的病历。对术后 CEA 水平进行了至少 12 个月的监测。假阳性 CEA 升高被定义为 CEA 水平超过 5 ng/mL，但影像学检查无复发证据：在接受检查的患者中，有 59 人（70%）在观察期内显示 CEA > 5 ng/mL。CEA水平升高对检测复发的敏感性和特异性分别为84%和41%。有 27 例患者出现 CEA 升高，但未发现肿瘤复发，假阳性率为 59%。这些患者中有一半以上的 CEA 峰值水平在 5 至 10 纳克/毫升之间，只有真阳性患者的 CEA 水平超过 40.0 纳克/毫升：结论：半数以上术后未复发的 PDAC 患者的 CEA 可能会升高。结论：半数 PDAC 患者术后 CEA 可能升高，但不会复发。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.