The correlation of tumor markers, neutrophil/lymphocyte ratio and FDG PET/CT measures in pancreatic cancer

Objective:This review will outline the correlation of tumor markers and NLR (Neutrophil/lymphocyte ratio) with measures such as MTV (mean total volume), TLG (total lesion glycolysis), and SUV (standart uptake value) in 18F FDG PET/CT in pancreatic carcinoma with the goal of selection of appropriate treatment modality and decrease rates of treatment failure and recurrences in pancreatic carcinoma by using tumor markers. In this way, we can predict the results of imaging modalities, using easy lab technics such as NLR and tm markers. Methods:45 patients that new diagnosed pancreatic cancer were included in the study. Diagnosis were confirmed by cytology. Their tumor marker levels (CA 19.9, CEA and AFP), NLR and PET/CT measurements (SUVmax, SUVmean, TLG, MTV) were obtained. Patients that already diagnosed, followed up or treated by oncology department, were excluded. Results:When tumor markers were compared with PET/CT measurements (SUVmax, SUVmean, TLG, MTV and tumor size) there were no significant difference between them. Also, total uptake values of organs (liver, spleen, pancreas) were not related with tm marker levels. However, there were positive significant correlation between tumor size and SUVmax, SUVmean, TLG (p=0.02 r = 0.347, p=0.022 r = 0.340, p=0.008 r =0.392). Conclusions:Tumor markers may help diagnosing or managing of pancreatic malignities, but we cannot predict PET/CT results according to tumor marker levels. So, tumor markers must be used as an adjunctive method for diagnosing malignities. They cannot be major determiner for malignities. Diagnosing and following up malignities should be supported by other laboratory technics and imaging methods.