Meriç Emre BOSTANCI, Murat Can MOLLAOĞLU, Kürşat KARADAYI

Pankreas Karsinomu Nedeniyle Ameliyat Edilen Hastalarda Serum CA 19-9 Düzeyleri ile Tümörün Lenfovasküler ve Perinöral İnvazyonu ve Lenf Nodu Metastazı Arasındaki İlişki

Amaç: Bu çalışmanın amacı pankreas kanseri nedeniyle ameliyat edilen hastalarda serum CA 19-9 düzeyleri ile lenfovasküler ve perinöral invazyon ve lenf nodu metastazı arasındaki ilişkiyi belirlemektir. Gereç ve Yöntem: Sivas Cumhuriyet Üniversitesi Cerrahi Onkoloji Kliniği’nde, pankreatikoduodenektomi veya distal pankreatektomi uygulanan 32 hastanın verileri, CA 19-9 düzeyleri retrospektif olarak incelendi. Patoloji raporları incelenerek lenfovasküler ve perinöral invazyon varlığı, lenf nodu metastazı değerlendirildi. Bulgular: Lenfovasküler invazyonu olan hastalarda ortalama serum CA 19-9 seviyeleri 242,38 U/mL, olmayan hastalarda ortalama serum CA19-9 seviyeleri 31,73 U/mL idi. Perinöral invazyonu olan hastalarda ortalama serum CA19-9 seviyeleri 220,93 U/mL idi, olmayan hastalarda ortalama serum CA 19-9 seviyeleri 15,23 U/mL idi. Lenf nodu metastazı olan hastalarda ortalama serum CA19-9 seviyeleri 238,52 U/mL, lenf nodu metastazı olmayan hastalarda ortalama serum CA 19-9 seviyeleri 35,16 U/mL idi. Serum CA19-9 değeri 16,25 U/ml lenfovasküler invazyon için %84,7 ve perinöral invazyon için %91,8 pozitif sonuç verir. Serum CA19-9 değeri, 27,06 U/mL lenf nodu metastazı için %85,9’luk bir pozitif sonuç vermektedir. Sonuç: Serum CA 19-9 değerleri 16,25 U/mL’nin üzerinde olan hastalarımızın %94,44’ünde lenfovasküler invazyon, %90,48’inde perinöral invazyon saptandı. Serum CA 19-9 değerleri 27,06 U/mL’nin üzerinde olan hastalarımızın %80,7’sinde lenf nodu metastazı saptandı. Ameliyattan önce, tümörün lenfovasküler ve perinöral invazyon olasılığını, lenf nodu metastazını tahmin etmek, daha geniş bir ameliyat yapma ve adjuvan, neoadjuvan tedavi yapma kararını vermek önemlidir ve serum CA 19-9 düzeyi bu konuda büyük fayda sağlamaktadır.

Relationship Between Serum CA 19-9 Levels and Lymphovascular and Perineural Invasion of the Tumor and Lymph Node Metastasis in Patients Operated due to Pancreatic Carcinoma

Objectives: The aim of this study was to determine the relationship between serum CA 19-9 levels and lymphovascular and perineural invasion and lymph node metastasis in patients operated due to pancreatic cancer. Materials and Methods: A total of 32 patients underwent pancreaticoduodenectomy or distal pancreatectomy at Sivas Cumhuriyet University Department of Surgical Oncology. CA 19-9 values were evaluated by retrospectively examining the data of the patients. By examining the pathology reports, the presence of lymphovascular and perineural invasion and lymph node metastasis was evaluated. Results: The mean serum CA 19-9 level in patients with lymphovascular invasion was 242.38 U/mL, and the mean serum CA 19-9 level in patients without lymphovascular invasion was 31.73 U/mL. The mean serum CA 19-9 level was 220.93 U/mL in patients with perineural invasion and 15.23 U/mL in patients without perineural invasion. The mean serum CA 19-9 level was 238.52 U/mL in patients with lymph node metastasis and 35.16 U/ mL in patients without lymph node metastasis. A value of 16.25 U/mL of serum CA 19-9 gives a positive result of 84.7% for lymphovascular invasion and 91.8% for perineural invasion. A value of 27.06 U/mL of serum CA 19-9 gives a positive result of 85.9% for lymph node metastasis. Conclusion: Lymphovascular invasion was detected in 94.44% and perineural invasion was detected in 90.48% of our patients with serum CA19- 9 values above 16.25 U/mL. Lymph node metastasis was detected in 80.7% of our patients with serum CA19-9 values above 27.06 U/mL. Before surgery, it is important to predict the probability of lymphovascular and perineural invasion of the tumor and lymph node metastasis, and to make the decision to perform broader surgery and perform adjuvant, neoadjuvant therapy and serum CA19-9 levels are of great benefit in this regard.

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