• Jae Ri Kim, Jin-Young Jang, Mee Joo Kang, Taesung Park, Seung Yeoun Lee, Woohyun Jung, Jihoon Chang, Youngchan Shin, Youngmin Han, and Sun-Whe Kim.
• Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 110-744, South Korea.
• J Hepatobiliary Pancreat Sci. 2015 Sep 1; 22 (9): 699-707.

BackgroundLittle is known about the prognostic significance of serum carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) concentrations for predicting malignancy in patients with intraductal papillary mucinous neoplasm (IPMN) of pancreas.MethodThe study cohort consisted of 367 patients with surgical biopsy proven IPMN at Seoul National University Hospital. Preoperative serum tumor markers were evaluated and compared with other clinical variables.ResultsMalignant pathology (high grade dysplasia [HGD] and invasive IPMN) was identified in 117 (31.9%) patients. Elevated serum CA19-9 was more frequent in patients with malignant (34.2%, P < 0.001; invasive IPMN vs. HGD 47.9% vs. 11.4%, P < 0.001) and main duct type (40.0%, P = 0.003) IPMN. Multivariate analysis showed main pancreatic duct (MPD) >5 mm (P < 0.001), mural nodules (P < 0.001), and elevated serum CA19-9 (P < 0.001) were independent predictors of malignancy. The sensitivity, specificity and accuracy were 34.2%, 92.4%, and 73.8%, respectively, for elevated serum CA19-9; 63.3%, 78.0%, and 73.3%, for MPD >5 mm; and 59.0%, 86.4%, and 77.7%, for mural nodules.ConclusionSerum CA19-9 is significantly higher in patients with malignant IPMN, especially in patients with invasive and main duct type IPMN. The diagnostic power of serum CA19-9 in predicting malignancy is comparable to that of MPD >5 mm and mural nodules.© 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

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