Diagnostic Performance of Platelet-to-Lymphocyte Ratio and CA19-9 Added to EUS-FNA for Solid Pancreatic Lesions: A Single-Center Retrospective Study.

Authors

Shasha Liu, Chen Hu, Yujing Fan, Lina Liu, Ying Hu

Published in

International journal of general medicine. Volume 19. Pages 610635. Epub Aug 25, 2026.

Abstract

To evaluate the incremental diagnostic value of the platelet-to-lymphocyte ratio (PLR) and carbohydrate antigen 19-9 (CA19-9) when combined with endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in patients with solid pancreatic lesions.
This retrospective single-center study included 127 consecutive patients who underwent EUS-FNA for solid pancreatic lesions between December 29, 2020, and October 23, 2023. Final diagnoses were established using a reference standard independent of the index EUS-FNA. Malignancy was confirmed by surgical pathology, independent cytologic or histologic evidence, or unequivocal radiologic progression or metastasis. Non-malignancy was established by independent benign pathology or lesion stability or regression without anticancer therapy during at least 24 months of clinical and imaging follow-up.
Among 127 patients, 80 had malignant lesions and 47 had non-malignant lesions. EUS-FNA achieved an accuracy of 91.3%, sensitivity of 93.8%, specificity of 87.2%, positive predictive value of 92.6%, and negative predictive value of 89.1%. CA19-9 levels were significantly higher in malignant than in non-malignant lesions (median [IQR], 197.21 [9.51-928.36] vs 14.30 [3.97-211.02] U/mL; P=0.001), with an AUC of 0.692. The PLR plus CA19-9 model yielded an apparent AUC of 0.734 and an optimism-corrected AUC of 0.717. The EUS-FNA plus PLR plus CA19-9 model showed the highest discrimination, with an apparent AUC of 0.986 (bootstrap 95% CI, 0.962-1.000) and an optimism-corrected AUC of 0.981; the corresponding Brier scores were 0.033 and 0.041.
EUS-FNA demonstrated high diagnostic accuracy for solid pancreatic lesions. PLR and CA19-9 provided complementary diagnostic value, and the three-variable model showed high diagnostic performance after internal validation.

PMID:
42668854
Bibliographic data and abstract were imported from PubMed on 30 Aug 2026.

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