The additive value of CA19.9 monitoring in a pancreatic cyst surveillance program
BackgroundSurveillance of pancreatic cysts focuses on the detection of (mostly morphologic) features warranting surgery. European guidelines consider elevated CA19.9 as a relative indication for surgery. We aimed to evaluate the role of CA19.9 monitoring for early detection and management in a cyst...
Elmentve itt :
| Szerzők: | |
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| Dokumentumtípus: | Cikk |
| Megjelent: |
2023
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| Sorozat: | UNITED EUROPEAN GASTROENTEROLOGY JOURNAL
11 No. 7 |
| Tárgyszavak: | |
| doi: | 10.1002/ueg2.12422 |
| mtmt: | 34466227 |
| Online Access: | http://publicatio.bibl.u-szeged.hu/29528 |
| LEADER | 03968nab a2200589 i 4500 | ||
|---|---|---|---|
| 001 | publ29528 | ||
| 005 | 20240212100843.0 | ||
| 008 | 240212s2023 hu o 000 eng d | ||
| 022 | |a 2050-6406 | ||
| 024 | 7 | |a 10.1002/ueg2.12422 |2 doi | |
| 024 | 7 | |a 34466227 |2 mtmt | |
| 040 | |a SZTE Publicatio Repozitórium |b hun | ||
| 041 | |a eng | ||
| 100 | 1 | |a Levink Iris J. M. C. | |
| 245 | 1 | 4 | |a The additive value of CA19.9 monitoring in a pancreatic cyst surveillance program |h [elektronikus dokumentum] / |c Levink Iris J. M. C. |
| 260 | |c 2023 | ||
| 300 | |a 601-611 | ||
| 490 | 0 | |a UNITED EUROPEAN GASTROENTEROLOGY JOURNAL |v 11 No. 7 | |
| 520 | 3 | |a BackgroundSurveillance of pancreatic cysts focuses on the detection of (mostly morphologic) features warranting surgery. European guidelines consider elevated CA19.9 as a relative indication for surgery. We aimed to evaluate the role of CA19.9 monitoring for early detection and management in a cyst surveillance population. MethodsThe PACYFIC-registry is a prospective collaboration that investigates the yield of pancreatic cyst surveillance performed at the discretion of the treating physician. We included participants for whom at least one serum CA19.9 value was determined by a minimum follow-up of 12 months. ResultsOf 1865 PACYFIC participants, 685 met the inclusion criteria for this study (mean age 67 years, SD 10; 61% female). During a median follow-up of 25 months (IQR 24, 1966 visits), 29 participants developed high-grade dysplasia (HGD) or pancreatic cancer. At baseline, CA19.9 ranged from 1 to 591 kU/L (median 10 kU/L [IQR 14]), and was elevated (& GE;37 kU/L) in 64 participants (9%). During 191 of 1966 visits (10%), an elevated CA19.9 was detected, and these visits more often led to an intensified follow-up (42%) than those without an elevated CA19.9 (27%; p < 0.001). An elevated CA19.9 was the sole reason for surgery in five participants with benign disease (10%). The baseline CA19.9 value was (as continuous or dichotomous variable at the 37 kU/L threshold) not independently associated with HGD or pancreatic cancer development, whilst a CA19.9 of & GE; 133 kU/L was (HR 3.8, 95% CI 1.1-13, p = 0.03). ConclusionsIn this pancreatic cyst surveillance cohort, CA19.9 monitoring caused substantial harm by shortening surveillance intervals (and performance of unnecessary surgery). The current CA19.9 cutoff was not predictive of HGD and pancreatic cancer, whereas a higher cutoff may decrease false-positive values. The role of CA19.9 monitoring should be critically appraised prior to implementation in surveillance programs and guidelines. | |
| 650 | 4 | |a Klinikai orvostan | |
| 700 | 0 | 1 | |a Jaarsma Sanne |e aut |
| 700 | 0 | 1 | |a Koopmann Brechtje D. M. A. |e aut |
| 700 | 0 | 2 | |a van Riet Priscilla A. |e aut |
| 700 | 0 | 2 | |a Overbeek Kasper |e aut |
| 700 | 0 | 2 | |a Meziani Jihane |e aut |
| 700 | 0 | 2 | |a Sprij Marloes L. J. A. |e aut |
| 700 | 0 | 2 | |a Casadei Riccardo |e aut |
| 700 | 0 | 2 | |a Ingaldi Carlo |e aut |
| 700 | 0 | 2 | |a Polkowski Marcin |e aut |
| 700 | 0 | 2 | |a Engels Megan M. L. A. |e aut |
| 700 | 0 | 2 | |a van der Waaij Laurens |e aut |
| 700 | 0 | 2 | |a Carrara Silvia |e aut |
| 700 | 0 | 2 | |a Pando Elizabeth |e aut |
| 700 | 0 | 2 | |a Vornhuelz Marlies |e aut |
| 700 | 0 | 2 | |a Honkoop Pieter J. |e aut |
| 700 | 0 | 2 | |a Schoon Erik |e aut |
| 700 | 0 | 2 | |a Laukkarinen Johanna F. |e aut |
| 700 | 0 | 2 | |a Bergmann Jilling |e aut |
| 700 | 0 | 2 | |a Rossi Gemma |e aut |
| 700 | 0 | 2 | |a van Vilsteren Frederike G. I. |e aut |
| 700 | 0 | 2 | |a van Berkel Anne-Marie |e aut |
| 700 | 0 | 2 | |a Tabone Trevor P. |e aut |
| 700 | 0 | 2 | |a Schwartz Matthijs |e aut |
| 700 | 0 | 2 | |a Tan Adriaan C. I. T. L. E. |e aut |
| 700 | 0 | 2 | |a van Hooft Jeanin |e aut |
| 700 | 0 | 2 | |a Quispel Rutger |e aut |
| 700 | 0 | 2 | |a van Soest Ellert |e aut |
| 700 | 0 | 2 | |a Czakó László |e aut |
| 700 | 0 | 2 | |a Bruno Marco L. |e aut |
| 700 | 0 | 2 | |a Cahen Djuna L. |e aut |
| 700 | 0 | 2 | |a Kollaborációs szervezet: PACYFIC‐registry work group |e aut |
| 856 | 4 | 0 | |u http://publicatio.bibl.u-szeged.hu/29528/1/Levink.pdf |z Dokumentum-elérés |