Endocrine Abstracts

Introduction: Neuroendocrine neoplasms (NENs) are rare heterogenous tumors which prevalence is increasing. Functional pancreatic neuroendocrine neoplasms (p-NENs) develop characteristic clinical syndromes in contrast to non-functional tumors that are diagnosed accidentally or at an advanced stage due to the lack of sensitive and specific biomarkers that could predict their clinical course.

Aim: This study aimed to assess tumor markers (TMs) in patients with p-NENs and their association with disease extent (metastatic vs. nonmetastatic disease).

Methods: 115 patients with p-NENs and 40 patients from the control group were enrolled. TMs levels, such as cytokeratin 18 (CY18), ferritin, carbohydrate antigen 19-9 (CA19-9), cancer antigen 125 (CA125), alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), and beta-2-microglobulin (BMG) were determined.

Results: The majority of the patients with p-NENs were non-functional (108/115) and well-differentiated (NET G1 (60/115) and NET G2 (47/115)). TMs levels in the patients with p-NENs were significantly higher than in the control group (P < 0.01), except for CA125 and AFP. The area under the curve (AUC) for CY18, CA19-9, and ferritin in patients with p-NENs was significantly higher than in the control group (P < 0.001), and their accuracy for detecting patients with p-NENs cases compared to the control group was 68%, 73%, and 77%, respectively. The CY18, CA125, and CEA levels were elevated in metastatic disease irrespective of PNEN grade (M-WU/t, P=0.01, P=0.02, and P=0.01, respectively). The AUC for differentiating metastatic from nonmetastatic disease in p-NENs was < 0.7 in these markers (P < 0.05).

Conclusions: The CY18, CA19-9, and ferritin can be used as additional tumor markers in diagnostics patients with p-NENs. The CY18, CA125, and CEA could be useful for diagnostic and prognostic purposes in patients with metastatic disease.