Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine-Needle Aspiration Cytology, Carcinoembryonic Antigen, and Amylase in Intraductal Papillary Mucinous Neoplasm

Abstract

Cytology has a limited role because of its lack of sensitivity. Carcinoembryonic antigen modestly differentiated between mucinous and nonmucinous lesions. Amylase did not distinguish IPMNs versus MCAs.

Early Detection of Pancreatic Cancer: Opportunities and Challenges

“…Kromrey et al 121 found no incidence of pancreatic cancer during a 5-year follow-up study of 676 patients with pancreatic cysts. Similarly, Moris et al 37 identified no cases of malignancy among 112 BD-IPMNs with more than 5 years of follow-up. In contrast, Del Chiaro et al 122 reported an IPMN-related mortality of 5.8% after a 10-year follow-up period in patients without highrisk features at baseline.…”

“…28 Other symptoms that include back pain, weight loss, NOD, and obstructive jaundice are more often associated with malignant transformation of an IPMN but, once again, are not entirely specific. [29][30][31][32]34,35,37,[46][47][48][49][50][51][52] Considering the lack of symptoms in most patients, conventional imaging modalities play a crucial role in the identification of IPMNs and IPMN-associated PDAC, as well as in the detection of a concomitant carcinoma. Here, we discuss the performance of imaging modalities used in the context of cystic lesions; later, we discuss choice of imaging in the context of solid lesions (noncystic PDAC).…”

“…Among BD-IPMN patients, 10%-45% have a history of diabetes and, in the setting of diabetes, the incidence of detecting a BD-IPMN is higher. [29][30][31][32][33][34][35][36][37] Capurso et al 38 identified a strong association between insulin use and the risk of an IPMN. Moreover, diabetes is associated with a higher incidence of PDAC in resected IPMNs.…”

Management of Intraductal Papillary Mucinous Neoplasms: Controversies in Guidelines and Future Perspectives

“…There is a causative link between IPMN and DM. Of patients with IPMN, 10–45% have diabetes [ 11 – 14 , 16 , 19 , 31 , 36 , 37 ] and in the case of diabetes, the risk of detecting IPMN is higher (OR 1.79; 95% CI 1.08–2.98) [ 35 ], especially in the case of insulin-use (OR 6.03, 95% CI 1.74–20.84) [ 35 ]. In reverse, the presence of DM is associated with a higher risk of HGD (OR 2.02, 95% CI 1.02–4.01) and carcinoma (OR 2.05, 95% CI 1.08–3.87) [ 38 ].…”

“…Of patients with IPMN, 13–32% are reported to present with secondary acute (recurrent) pancreatitis, although this incidence is based on surgical series and likely to be overestimated. Other symptoms are weight loss, new-onset diabetes, steatorrhea and back pain [ 11 – 15 , 17 – 20 , 31 , 37 , 39 – 41 ].…”