e128 Scientific Poster Presentations: 2017 Clinical Congress
site for 10 patients, gastrointestinal NETs for 14 patients, bron-
chial carcinoid for 5, large call NEC for 3, Merkel cell carcinoma
for two and pheochromocytoma in one patient.
CONCLUSIONS: Tissue type ID was able to identify a primary
site in NETs of unknown primary in majority (94.7%) of cases.
The result had direct implication in management of patients
with regards to FDA approved treatment options in 13 out of 38
patients (PNETs, merkel cell and pheochromocytoma).
Serum Albumin: A Good Indicator of
28-Day-Mortality in Acute Pancreatitis
Shoukang Li, MD, Heshui Wu, MD, PhD, Yushun Zhang, MD
Wuhan Union Hospital, Wuhan, China
INTRODUCTION: To evaluate the predictive value of serum albu-
min (ALB) on admission for 28-day-mortality in acute pancreatitis
(AP).
METHODS: From January 2009 to December 2015, 729 patients
with AP were included in this retrospective study. Overall, 171 pa-
tients were diagnosed with POF (persistent organ failure), of which
54 patients died within 28 days. All the values of laboratory param-
eters were measured upon admission to hospital. Uni- and multi-
variate logistic regression were used to evaluate the impact of
ALB to predict mortality. A Kaplan-Meier method was used to
do survival analysis. All analyses were done for all patients first
and for patients with POF then.
RESULTS: The median age of the whole population was 46 years
and 58.7% were male. The admission-time serum albumin of the
nonsurvivors of AP patients was distinctly lower than patients who
survived (25.7 (21.2-29.4) g/L vs 36.0 (32.6-39.2) g/L, p<0.01).
Even through the analysis among the 171 patients with POF, non-
survivors’ serum albumin was still extremely lower than those alive
at last (25.7 (21.2-29.4) g/L vs 29.0 (24.9-33.1) g/L, p<0.01). Af-
ter univariate and multivariate regression analysis, ALB remained
an independent prognostic factor for mortality in AP (OR:
0.847, 95% CI: 0.778-0.922; p<0.01). The area under to curve
for ALB is 0.897 (0.863, 0.932). The survival time of patients
with higher level of serum albumin is distinctly longer, 27.832
(27.671, 27.993) vs 24.305 (23.314, 25.296) for all patients and
25.977 (24.139, 27.815) vs 21.938 (20.450, 23.425) for patients
with POF, p<0.01.
CONCLUSIONS: We identified serum albumin predictive to
28-day-mortality in acute pancreatitis.
Clinical Significance of the Serum
Concentration of Duke Pancreatic
Monoclonal Antigen Type 2 (DUPAN-2) in
Biliary Tract Cancer
Tokuji Ito, MD, Shogo Tanaka, MD, PhD, Shigekazu Takemura,
Genya Hamano, Yukiko Kurashima, Takanori Aota, Masaki Koda,
Shoji Kubo
Osaka City University Graduate School of Medicine, Osaka,
Japan
J Am Coll Surg
INTRODUCTION: DUPAN-2, which is an important serum tu-
mor marker in pancreatic cancer, is elevated in some patients
with biliary tract cancer (BTC). However, the optimal cutoff values
for the diagnosis of BTC and the clinical significance of serum
DUPAN-2 in BTC have not been investigated.
METHODS: The serum concentrations of DUPAN-2, carcinoem-
bryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9)
were prospectively measured in 83 patients with BTC and 35 pa-
tients with benign biliary tract disease (as a control) before surgery.
The accuracy of the serum concentration of DUPAN-2 as a tumor
marker was investigated.
RESULTS: The receiving operating characteristic curve for the
serum concentration of DUPAN-2 in predicting BTC demon-
strated a greater area under the curve (0.818) in comparison to
the serum concentrations of CA19-9 (0.780) and CEA (0.660).
The sensitivity and specificity of DUPAN-2, CA19-9, and CEA
were 74.8% and 82.9%, 54.2% and 88.6%, 24.1% and 91.4%,
respectively. The diagnostic accuracy (positive predictive value +
negative predictive value) of DUPAN-2 (77.1%) was higher than
that of CA19-9 (63.6%) and CEA (44.1%). No correlations be-
tween DUPAN-2 and CA19-9 and CEA were found, and 14
(41.2%) of the 34 patients who were negative for either CA19-9
or CEA were positive for DUPAN-2, whereas 7 (33.3%) of 21 pa-
tients who were negative for DUPAN-2 were positive for either
CA19-9 or CEA.
CONCLUSIONS: The measurement of the serum concentration of
DUPAN-2 in addition to CA19-9 and CEA was considered helpful
for diagnosing BTC.
Prognostic Value of Varying Definitions of
Positive Resection Margin in Patients with
Colorectal Liver Metastases
Georgios Antonios Margonis, MD, PhD, Neda Amini, MD,
Jane Wang, Nikolaos Andreatos, MD, Neda Rezaee, Stefan Buettner,
Amar Deshwar, MD, Kazunari Sasaki, MD,
Christopher L Wolfgang, MD, PhD, Matthew J Weiss, MD
Johns Hopkins University, Sinai Hospital, Baltimore, MD
INTRODUCTION: Varying definitions of resection margin clear-
ance are currently employed among patients with colorectal cancer
liver metastasis (CRLM). Specifically, a microscopically positive
margin (R1) has alternatively been equated with an involved
margin (margin width¼0mm), or a margin width <1mm. Conse-
quently, patients with a margin width of 0-1mm are inconsistently
classified in either the R0 or R1 categories, thus obscuring the prog-
nostic implications of sub-mm margins.
METHODS: A total of 633 patients who underwent curative-intent
resection of CRLM at a single institution were identified. Both R1
definitions were employed separately and multivariable analysis was
used to determine the predictive power of each definition, as well as
the prognostic implications of a sub-mm margin.
RESULTS: Ninety-four (14.8%) patients had a margin width
<1mm, which was associated with worse overall survival (OS) in