The Diagnostic Value of the CA19-9 and Bilirubin Ratio in Patients with Pancreatic Cancer, Distal Bile Duct Cancer and Benign Periampullary Diseases, a Novel Approach
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Le résumé fourni par la source
Distinction of pancreatic ductal adenocarcinoma (PDAC) in the head of the pancreas, distal cholangiocarcinoma (dCCA), and benign periampullary conditions, is complex as they often share similar clinical symptoms. However, these diseases require specific management strategies, urging improvement of non-invasive tools for accurate diagnosis. Recent evidence has shown that the ratio between CA19-9 and bilirubin levels supports diagnostic distinction of benign or malignant hepatopancreaticobiliary diseases. Here, we investigate the diagnostic value of this ratio in PDAC, dCCA and benign diseases of the periampullary region in a novel fashion. To address this aim, we enrolled 265 patients with hepatopancreaticobiliary diseases and constructed four logistic regression models on a subset of patients (n = 232) based on CA19-9, bilirubin and the ratio of both values: CA19-9/(bilirubin−1). Non-linearity was investigated using restricted cubic splines and a final model, the ‘Model Ratio’, based on these three variables was fitted using multivariable fractional polynomials. The performance of this model was consistently superior in terms of discrimination and calibration compared to models based on CA19-9 combined with bilirubin and CA19-9 or bilirubin alone. The ‘Model Ratio’ accurately distinguished between malignant and benign disease (AUC [95% CI], 0.91 [0.86–0.95]), PDAC and benign disease (AUC 0.91 [0.87–0.96]) and PDAC and dCCA (AUC 0.83 [0.74–0.92]) which was confirmed by internal validation using 1000 bootstrap replicates. These findings provide a foundation to improve minimally-invasive diagnostic procedures, ultimately ameliorating effective therapy for PDAC and dCCA.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- The Diagnostic Value of the CA19-9 and Bilirubin Ratio in Patients with Pancreatic Cancer, Distal Bile Duct Cancer and Benign Periampullary Diseases, a Novel Approach
- Date Crossref
- 11/01/2022
- Éditeur
- MDPI AG
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Amsterdam UMC Location Vrije Universiteit Amsterdam pays non établi dans la noticeÉtablissement de santé
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Erasmus MC Department of Surgery pays non établi dans la noticeÉtablissement de santé
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Westfriesgasthuis pays non établi dans la noticeÉtablissement de santé
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Dijklander Ziekenhuis pays non établi dans la noticeÉtablissement de santé
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Fondazione Pisa pays non établi dans la noticeOrganisation à but non lucratif
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Amsterdam University Medical Centers pays non établi dans la noticeÉtablissement de santé
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University of Amsterdam Department of Medical Oncology pays non établi dans la noticeUniversité ou école supérieure
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VU University Medical Center (VUmc) Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
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Department of Surgery pays non établi dans la noticeInstitution
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Cancer Pharmacology Lab pays non établi dans la noticeStructure de recherche
Amsterdam UMC Location Vrije Universiteit Amsterdam, Department of Surgery — Erasmus MC et Westfriesgasthuis, avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.