Abstract
BackgroundSerum ferritin levels are elevated in many malignancies. In this study, we showed the performance of serum ferritin in identifying malignant intraductal papillary mucinous neoplasms (IPMNs).MethodsA total of 151 patients with pathologically confirmed IPMNs were enrolled. Serum tumor biomarker (carbohydrate antigen 19–9 (CA19–9) and carcinoembryonic antigen (CEA)) levels and serum ferritin levels were recorded. Lesion location, tumor size, diameter of the main pancreatic duct (MPD), mural nodule, and IPMN type, were collected from imaging examinations. IPMNs with high grade dysplasia and associated invasive carcinoma were considered malignant IPMNs.ResultsSerum ferritin levels in patients with malignant IPMNs were higher than those in patients with nonmalignant IPMNs (p < 0.05). Serum ferritin was an independent factor for the occurrence of malignant IPMNs (odds ratio (OR) = 1.18, 95% confidence interval (CI):1.01–1.39). A similar trend was found between high serum ferritin (> 149 ng/ml) and malignant IPMNs (OR = 5.64, 95% CI:1.78–17.92). The area under the curve (AUC) of serum ferritin was higher than that of CEA and CA19–9 in identifying malignant IPMNs (AUC = 0.67 vs. AUC = 0.58, 0.65). The combination of serum ferritin with IPMN type showed a similar performance to MPD diameter and the combination of serum CA19–9 with IPMN types in identifying malignant IPMNs (AUC = 0.78 vs. AUC = 0.79, 0.77) and invasive carcinoma (AUC = 0.77 vs. AUC = 0.79, 0.79).ConclusionsElevated serum ferritin is a factor associated with malignant IPMNs. Serum ferritin may be a useful marker for identifying malignancy in IPMNs.
Highlights
Intraductal papillary mucinous neoplasms (IPMNs) represent one type of cystic pancreatic neoplasms
Hirono et al showed that carcinoembryonic antigen (CEA) in the pancreatic juice was a biomarker of carcinomas in MD- and mixed type (MT)-INTRADUCTAL papillary mucinous neoplasms (IPMN) [8]
Most nonmalignant IPMNs were branch duct (BD)-IPMNs; in contrast, malignant IPMNs was commonly seen among MD-IPMNs
Summary
Intraductal papillary mucinous neoplasms (IPMNs) represent one type of cystic pancreatic neoplasms. Whether other potential high-risk factors exist for identifying malignant IPMNs needs to be further explored. Hirono et al showed that carcinoembryonic antigen (CEA) in the pancreatic juice was a biomarker of carcinomas in MD- and MT-IPMNs [8]. They found that serum carbohydrate antigen 19–9 (CA19–9) was independently related to malignancy in MT-IPMNs [7]. Previous guidelines have not reported other potential serum biomarkers in the management of IPMNs. Serum ferritin levels are elevated in many malignancies. We showed the performance of serum ferritin in identifying malignant intraductal papillary mucinous neoplasms (IPMNs)
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