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

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)3358-3364
Number of pages7
JournalAnnals of Surgical Oncology
Volume25
Issue number11
DOIs
Publication statusPublished - 01-10-2018
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

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