Clinical diagnosis and management of pancreatic mucinous cystadenoma and cystadenocarcinoma: Single-center experience with 82 patients

Zhao, Zhiming; Jiang, Nan; Gao, Yu; Yin, Zhongyuan; Zhao, Guodong; Tan, Xiaojie; Xu, Yiming; Liu, Rong

doi:10.4251/wjgo.v12.i6.642

Cited by 10 publications

(14 citation statements)

References 27 publications

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“…Nevertheless, we identified that serum CA125 was more likely a predictor of advanced MCN than advanced IPMN. The results were similar to those of two recently published studies[ 25 , 26 ]. The possible reason may be the tissue histogenesis of MCN.…”

Section: Discussionsupporting

confidence: 92%

Validation of serum tumor biomarkers in predicting advanced cystic mucinous neoplasm of the pancreas

Sun

Peng

Guo

et al. 2021

WJG

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BACKGROUND Early detection of advanced cystic mucinous neoplasms [(A-cMNs), defined as high-grade dysplasia or malignancy] of the pancreas is of great significance. As a simple and feasible detection method, serum tumor markers (STMs) may be used to predict advanced intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs). However, there are few studies on the usefulness of STMs other than carbohydrate antigen (CA) 19-9 for early detection of A-cMNs. AIM To study the ability of five STMs-CA19-9, carcinoembryonic antigen (CEA), CA125, CA724, and CA242 to predict A-cMNs and distinguish IPMNs and MCNs. METHODS We mainly measured the levels of each STM in patients pathologically diagnosed with cMNs. The mean levels of STMs and the number of A-cMN subjects with a higher STM level than the cutoff were compared respectively to identify the ability of STMs to predict A-cMNs and distinguish MCNs from IPMNs. A receiver operating characteristic curve with the area under curve (AUC) was also created to identify the performance of the five STMs. RESULTS A total of 187 patients with cMNs were identified and 72 of them showed A-cMNs. We found that CA19-9 exhibited the highest sensitivity (SE) (54.2%) and accuracy (76.5%) and a moderate ability (AUC = 0.766) to predict A-cMNs. In predicting high-grade dysplasia IPMNs, the SE of CA19-9 decreased to 38.5%. The ability of CEA, CA125, and CA724 to predict A-cMNs was low (AUC = 0.651, 0.583, and 0.618, respectively). The predictive ability of CA242 was not identified. The combination of STMs improved the SE to 62.5%. CA125 may be specific to the diagnosis of advanced MCNs. CONCLUSION CA19-9 has a moderate ability, and CEA, CA125, and CA724 have a low ability to predict A-cMNs. The combination of STM testing could improve SE in predicting A-cMNs.

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Section: Discussionsupporting

confidence: 92%

Validation of serum tumor biomarkers in predicting advanced cystic mucinous neoplasm of the pancreas

Sun

Peng

Guo

et al. 2021

WJG

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“…Postlewait et al retrospectively identified 349 patients with MCN and demonstrated that patients with malignant neoplasms had a higher serum CA19-9 level than those without (median, 210 vs. 15 U/ml, P=0.001) ( 5 ). Zhao et al ( 17 ) showed that serum CA19-9 levels were significantly higher in malignant MCNs than in benign MCNs patients (P=0.026) for resected MCNs. Our study is consistent with previous findings, which finds that the serum levels of CA19-9 in the high grade and invasive group (309.2±423.2 U/ml) was significantly higher than those in the low/moderate grade group (49.0±198.3 U/ml, P=0.050), with an area under the ROC curve of 0.68.…”

Section: Discussionmentioning

confidence: 99%

“…However, cyst fluid CEA has limited role in predicting malignancy or radiographic progression mucinous cysts of the pancreas (18). Several studies have also determined circulating CEA in predicting malignant MCNs (14,16,17). For example, Zhao et al (17) demonstrated that serum CEA levels were significantly higher in malignant MCNs than in benign MCNs patients (P=0.005) for 82 patients with resected MCNs.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have also determined circulating CEA in predicting malignant MCNs (14,16,17). For example, Zhao et al (17) demonstrated that serum CEA levels were significantly higher in malignant MCNs than in benign MCNs patients (P=0.005) for 82 patients with resected MCNs. In this study, the serum levels of CEA in the high grade and invasive group (23.7±52.9 ng/ml) was significantly higher than those in the low/moderate grade group (8.7±82.6 ng/ml, P=0.018), with an area under the ROC curve of 0.72.…”

Section: Discussionmentioning

confidence: 99%

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Clinical implication of serum CA125 for the prediction of malignancy in mucinous cystic neoplasms of the pancreas

et al. 2020

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Mucinous cystic neoplasms (MCNs) of the pancreas have malignant potential. Carbohydrate antigen 125 (CA125) is a common widely used biomarker for cancers. However, the role of CA125 in predicting the malignant change of MCNs is currently unidentified. Patients with resected and pathologically confirmed MCN were identified from a prospectively maintained database. The predictive role of serum CA125 in assessing malignant change of MCNs was analyzed and compared with serum carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA). This study included 164 patients with MCN (low/moderate grade, 153 cases; high grade and invasive, 11 cases). The serum levels of CA125 in the high grade and invasive group (45.1±42.1 U/ml) was significantly higher than those in the low/moderate grade group (21.0±46.2 U/ml, P=0.006). The area under the receiver operating characteristic (ROC) curve of CA125 (0.75) for predicting malignancy of MCNs was higher than that of CA19-9 (0.68) or CEA (0.72). The prediction value of CA125 was improved when combined with CEA (CA125 alone, sensitivity 36.4%, specificity 90.6%, accuracy 86.6%; combined with CEA, sensitivity 45.5%, specificity 88.2%, accuracy 85.0%). It was concluded that serum CA125 shows value in predicting the malignant change of MCNs, especially when combined with serum CEA.

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“…Serous cystadenomas are rare glycogen-rich lesions, which arise from pancreatic ductal epithelium (10). But mucinous cystadenomas are cystic epithelial tumors, consisting of ovarian stromata and mucus-producing columnar epithelium (11). In clinical practice, most pancreatic cystadenoma patients are asymptomatic or manifest non-specific symptoms (12).…”

Section: Introductionmentioning

confidence: 99%

Application of CT-Based Radiomics in Discriminating Pancreatic Cystadenomas From Pancreatic Neuroendocrine Tumors Using Machine Learning Methods

et al. 2021

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ObjectivesThe purpose of this study aimed at investigating the reliability of radiomics features extracted from contrast-enhanced CT in differentiating pancreatic cystadenomas from pancreatic neuroendocrine tumors (PNETs) using machine-learning methods.MethodsIn this study, a total number of 120 patients, including 66 pancreatic cystadenomas patients and 54 PNETs patients were enrolled. Forty-eight radiomic features were extracted from contrast-enhanced CT images using LIFEx software. Five feature selection methods were adopted to determine the appropriate features for classifiers. Then, nine machine learning classifiers were employed to build predictive models. The performance of the forty-five models was evaluated with area under the curve (AUC), accuracy, sensitivity, specificity, and F1 score in the testing group.ResultsThe predictive models exhibited reliable ability of differentiating pancreatic cystadenomas from PNETs when combined with suitable selection methods. A combination of DC as the selection method and RF as the classifier, as well as Xgboost+RF, demonstrated the best discriminative ability, with the highest AUC of 0.997 in the testing group.ConclusionsRadiomics-based machine learning methods might be a noninvasive tool to assist in differentiating pancreatic cystadenomas and PNETs.

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Clinical diagnosis and management of pancreatic mucinous cystadenoma and cystadenocarcinoma: Single-center experience with 82 patients

Cited by 10 publications

References 27 publications

Validation of serum tumor biomarkers in predicting advanced cystic mucinous neoplasm of the pancreas

Validation of serum tumor biomarkers in predicting advanced cystic mucinous neoplasm of the pancreas

Clinical implication of serum CA125 for the prediction of malignancy in mucinous cystic neoplasms of the pancreas

Application of CT-Based Radiomics in Discriminating Pancreatic Cystadenomas From Pancreatic Neuroendocrine Tumors Using Machine Learning Methods

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