The predictive value of mean platelet volume in differential diagnosis of non-functional pancreatic neuroendocrine tumors from pancreatic adenocarcinomas

ObjectiveThe aim of the present study is to evaluate in a retrospective manner the diagnostic value of mean platelet volume (MPV) in pancreatic adenocarcinomas and pancreatic neuroendocrine tumors (PNETs).Patients and methodsA total of 92 patients, who were admitted for pancreatic adenocarcinoma (n = 76) and PNET (n = 16) between March 2007 and December 2009, were analyzed retrospectively for demographics and clinical information.ResultsThirty-nine patients (51.3%) had a resectable, whereas 37 patients (48.7%) had an unresectable pancreatic adenocarcinoma. Nine patients (56.3%) had a non-functional PNET, 6 patients (37.5%) had an insulinoma, and the remaining one patient had a gastrinoma. The mean age was 59.3 ± 10.5 for pancreatic adenocarcinomas and 45.1 ± 10.6 for PNETs. The mean age at diagnosis was significantly higher in patients with pancreatic adenocarcinomas than the patients with PNET (p < 0.001). Preoperative mean hemoglobin levels were significantly lower in patients with pancreatic adenocarcinoma than those with PNET (12.4 ± 1.8 g/dl vs 13.7 ± 2.2 g/dl), (p < 0.013). The preoperative median MPV levels were significantly lower in patients with PNET 7.8 fL (7.2–9.4) than in patients with pancreatic adenocarcinomas 8.6 fL (6.6–13.5), (p < 0.014). In subgroup analysis, a significant difference in MPV levels was mainly caused by the difference between pancreatic adenocarcinomas and non-functional PNETs (p = 0.017). The cut-off value of MPV level for detection of PNETs was calculated as ≤ 7.8 fL using ROC analysis [Sensitivity: 66.7%, specificity: 75.9%, AUC: 0.734 (0.587–0.880) p = 0.022]. In logistic regression analysis, independent predictive factors for determining PNETs in the differential diagnosis of pancreatic adenocarcinomas were calculated as age (OR = 0.068, 95% CI: 0.012–0.398), Ca 19–9 (OR = 0.039, 95% CI: 0.006–0.263), MPV (OR = 0.595, 95% CI: 0.243–1.458), and hemoglobin (OR = 1.317, 95% CI: 0.831–2.086).ConclusionAge, Ca 19–9, MPV, and hemoglobin levels have diagnostic value for distinguishing PNETs from pancreatic adenocarcinomas.