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Annals of Surgical Oncology

, Volume 25, Issue 11, pp 3358–3364 | Cite as

Serum Elastase 1 Level as a Risk Factor for Postoperative Recurrence in Patients with Well-Differentiated Pancreatic Neuroendocrine Neoplasms

  • Yoshihide Nanno
  • Hirochika Toyama
  • Yoh Zen
  • Masayuki Akita
  • Yasuhisa Ando
  • Takuya Mizumoto
  • Yuki Ueda
  • Tetsuo Ajiki
  • Keiichi Okano
  • Yasuyuki Suzuki
  • Takumi Fukumoto
Pancreatic Tumors
  • 114 Downloads

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.

Notes

Disclosure

All authors have no conflicts of interest and nothing to disclose.

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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • Yoshihide Nanno
    • 1
  • Hirochika Toyama
    • 1
  • Yoh Zen
    • 2
  • Masayuki Akita
    • 2
  • Yasuhisa Ando
    • 3
  • Takuya Mizumoto
    • 1
  • Yuki Ueda
    • 1
  • Tetsuo Ajiki
    • 1
  • Keiichi Okano
    • 3
  • Yasuyuki Suzuki
    • 3
  • Takumi Fukumoto
    • 1
  1. 1.Division of Hepato-Biliary-Pancreatic Surgery, Department of SurgeryKobe University Graduate School of MedicineKobeJapan
  2. 2.Department of Diagnostic PathologyKobe University Graduate School of MedicineKobeJapan
  3. 3.Department of Gastroenterological SurgeryKagawa University Faculty of MedicineKagawaJapan

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