Clinicopathological study of gastrointestinal pancreatic carcinoma with neuroendocrine differentiation and mixed adenocarcinoma of the pancreas and pancreas / 中国生化药物杂志

Objective To investigate the clinicopathological features of gastrointestinal carcinoma with neuroendocrine differentiation (NED) and mixed adenocarcinoma of the pancreas and pancreas (MANEC). Methods Clinical and pathological data of 29 cases in Zhejiang Chinese medicine hospital with gastrointestinal pancreatic cancer with neuroendocrine branch and 7 cases with gastrointestinal pancreatic MANEC patients were analyzed retrospectively. Hematoxylin eosin staining of the tissue (HE) and immunohistochemistry (IHC) were observed, the relationship between IHC index and tumor distant metastasis and clinical pathological indicators between. Results Gastrointestinal pancreatic cancer with NED and MANEC in patients with various clinicopathological parameters and IHC expression rate difference was not statistically significant;neuroendocrine index expression difference between the positive rate and clinical pathological factors were not statistically significant; there was no significant difference between distant metastasis and clinical pathological factors. Conclusion Combined with morphological HE staining and immunohistochemical IHC staining, gastrointestinal carcinoma with NED and MANEC has high heterogeneity. Clinical staging and grading are the major prognostic factors. Early diagnosis and treatment can improve the prognosis of patients.

Serum CA 19-9 and CEA Levels as a Prognostic Factor in Pancreatic Adenocarcinoma

PURPOSE: To investigate the use of pretreatment carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) as prognostic factors to determine survival in pancreatic adenocarcinoma. MATERIALS AND METHODS: A retrospective review of the medical records of patients who were diagnosed with pancreatic adenocarcinoma and received surgery, chemoradiotherapy or chemotherapy was performed. Factors, including CA 19-9 and CEA, associated with the survival of pancreatic cancer patients were analyzed. RESULTS: Patients with the median age of 65 years were included (n=187). Elevated serum CA 19-9 levels and CEA levels were observed in 75.4% and 39% of patients at diagnosis, respectively. CEA was correlated with tumor stages (p=0.005), but CA 19-9 was not. CA 19-9 and CEA were elevated in 69.0% and 33.3% of patients with resectable pancreatic cancer, and elevated in 72.9% and 47.2% of patients with advanced pancreatic cancer, respectively. The median overall survival of the normal serum CEA group was longer than that of the elevated serum CEA group (16.3 months vs. 10.2 months, p=0.004). However, the median overall survival of the normal serum CA 19-9 group was not different from that of the elevated serum CA 19-9 group (12.4 months vs. 13.5 months, p=0.969). The independent factors associated with overall survival were advanced pancreatic cancer [harzard ratio (HR) 4.33, p=0.001] and elevated serum CEA level (HR 1.52, p=0.032). CONCLUSION: Patients with elevated serum CEA level at diagnosis demonstrated poor overall survival. Pretreatment CEA level may predict the prognosis of patients with pancreatic adenocarcinoma.