Abstract | BACKGROUND: METHODS: RESULTS: Human pancreatic polypeptide had the highest agreement between an elevated serum level and positive tumor immunostaining (83% vs. 50% agreement for gastrin vs. 67% agreement for glucagon). Preoperative CT had 81% sensitivity and positive predictive value (PPV) of 97% for PNETs. ( 111)In pentetreotide scintigraphy had 84% sensitivity and PPV of 96%. Preoperative endoscopic ultrasonography (EUS) had 100% sensitivity and PPV, with close correlation (r (s) = 0.93) between the largest lesion seen on EUS and pathology. Median follow-up was 4.3 years (range = 0.1-10.9 years). Overall survival was 89% at 5-year follow-up. CONCLUSIONS: Our study substantiates EUS as providing the highest preoperative sensitivity and PPV in assessing the presence of PNETs in MEN 1 patients. CT and octreotide scintigraphy can yield both false-positive and false-negative results. HPP, gastrin, and glucagon were the most commonly measured tumor markers in our series but did not always correlate with immunostaining. With an aggressive surgical approach, satisfactory rates of biochemical improvement and long-term survival were observed.
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Authors | Mark A Lewis, Geoffrey B Thompson, William F Young Jr |
Journal | World journal of surgery
(World J Surg)
Vol. 36
Issue 6
Pg. 1375-81
(Jun 2012)
ISSN: 1432-2323 [Electronic] United States |
PMID | 22382771
(Publication Type: Comparative Study, Evaluation Study, Journal Article)
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Chemical References |
- Biomarkers
- Radiopharmaceuticals
- Somatostatin
- pentetreotide
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Topics |
- Adult
- Aged
- Biomarkers
(blood)
- Endosonography
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Multiple Endocrine Neoplasia Type 1
(blood, diagnosis, mortality, surgery)
- Neuroendocrine Tumors
(blood, diagnosis, mortality, surgery)
- Pancreatectomy
- Pancreatic Neoplasms
(blood, diagnosis, mortality, surgery)
- Preoperative Care
(methods)
- Radiopharmaceuticals
- Reproducibility of Results
- Retrospective Studies
- Sensitivity and Specificity
- Somatostatin
(analogs & derivatives)
- Survival Rate
- Tomography, X-Ray Computed
- Treatment Outcome
- Young Adult
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