Pancreatic cyst fluid glucose: rapid, inexpensive, and accurate diagnosis of mucinous pancreatic cysts

Carr, Rosalie A.; Yip-Schneider, Michele; Simpson, Rachel E.; Dolejs, Scott C.; Schneider, Justine G.; Wu, Hsin-Jung; Ceppa, Eugene P.; Park, Walter G.; Schmidt, C. Max

doi:10.1016/j.surg.2017.09.051

Cited by 65 publications

(58 citation statements)

References 27 publications

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“…There has been an interest in using cyst fluid glucose levels to differentiate IPMNs and MCNs from other types of cysts [28,29]. A recent study evaluated this in 153 patients all of whom had undergone surgical resection [30]. Using a cutoff of ≤50 mg/dl, cyst fluid glucose had 92% sensitivity and 87% specificity for identifying IPMNs and MCNs from other cyst types, and had a higher accuracy of 90 versus 69% compared with cyst fluid CEA [30].…”

Section: Intraductal Papillary Mucinous Neoplasms and Mucinous Cysticmentioning

confidence: 99%

Cyst Fluid Biomarkers - Diagnosis and Prediction of Malignancy for Cystic Lesions of the Pancreas

Raman

Lennon²

2018

Visc Med

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Pancreatic cysts are common, and are identified in 2-13% of individuals undergoing cross-sectional imaging. Intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) are pancreatic cysts which are precursors to pancreatic adenocarcinoma. Currently available tools are imperfect at differentiating IPMNs and MCNs from other, benign types of pancreatic cysts. The role of molecular markers in the evaluation of pancreatic cysts and the identification of cysts with high-grade dysplasia or invasive adenocarcinoma is reviewed.

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Section: Intraductal Papillary Mucinous Neoplasms and Mucinous Cysticmentioning

confidence: 99%

Cyst Fluid Biomarkers - Diagnosis and Prediction of Malignancy for Cystic Lesions of the Pancreas

Raman

Lennon²

2018

Visc Med

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“…Wu et al demonstrated 98% sensitivity and 100% specificity in diagnosing IPMN when testing cyst fluid [35]. Other single markers, such as glucose and neutrophil gelatinase-associated lipocalin (NGAL), have also been investigated with no ability to stratify IPMN [36][37][38]. Fortunately, there are now several single markers with the ability to both identify and grade IPMN dysplasia.…”

Section: Amylase < 250mentioning

confidence: 99%

Stratifying Intraductal Papillary Mucinous Neoplasms by Cyst Fluid Analysis: Present and Future

Hao

Takahashi

Snyder

et al. 2020

IJMS

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A significant proportion of patients with intraductal papillary mucinous neoplasms (IPMNs) undergo surgical resection in order to prevent or treat pancreatic cancer at the risk of significant perioperative morbidity. Efforts have been made to stratify the potential risk of malignancy based on the clinical and radiographic features of IPMN to delineate which cysts warrant resection versus observation. An analysis of the cyst fluid obtained by preoperative endoscopic examination appears to be correlative of cyst type and risk, whereas serum markers and radiographic findings have not yet reached a level of sensitivity or specificity that proves they are clinically meaningful. In this review, we investigate the current cyst fluid analysis studies and present those that have shown promise in effectively stratifying high-risk versus low-risk lesions. While new cyst fluid markers continue to be identified, additional efforts in testing panels and marker composites in conjunction with clinical algorithms have also shown promise in distinguishing dysplasia and the risk of malignancy. These should be tested prospectively in order to determine their role in guiding the surveillance of low-risk lesions and to evaluate the new markers detected by proteomics and genetic sequencing.

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“…Glucose in cyst fluid is a proposed new biomarker of interest for non-mucinous cystic lesions. Preliminary data are promising, yet its application is still investigational [81].…”

Section: Biochemical Markersmentioning

confidence: 99%

Endoscopic Management and Follow-Up of Intraductal Papillary Mucinous Neoplasia (IPMN)

Hoogenboom¹,

Fockens²,

Wallace³

et al. 2020

Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy

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Intraductal papillary mucinous neoplasms (IPMN) are common and increasingly detected in patients undergoing cross-sectional imaging for reasons unrelated to the pancreas. Individuals diagnosed with an IPMN should be followed over time because of the malignant potential of these cystic lesions. The primary goal of surveillance is to identify the small minority of IPMN that progresses into advanced neoplasia and benefits from resection, while simultaneously avoiding unnecessary pancreatic surgery in the majority of IPMN that remains benign. Cross-sectional imaging and endoscopic ultrasound with or without fluid and tissue acquisition are currently used to evaluate the risk of malignancy in IPMN. This chapter summarizes the diagnostic workup, surveillance, and treatment of IPMN, focusing on endoscopic modalities and adjacent tests.

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Pancreatic cyst fluid glucose: rapid, inexpensive, and accurate diagnosis of mucinous pancreatic cysts

Abstract: Cyst fluid glucose has significant advantages over carcinoembryonic antigen and should be considered for use as a routine diagnostic test for pancreatic mucinous cysts.

Cited by 65 publications

References 27 publications

Cyst Fluid Biomarkers - Diagnosis and Prediction of Malignancy for Cystic Lesions of the Pancreas

Cyst Fluid Biomarkers - Diagnosis and Prediction of Malignancy for Cystic Lesions of the Pancreas

Stratifying Intraductal Papillary Mucinous Neoplasms by Cyst Fluid Analysis: Present and Future

Endoscopic Management and Follow-Up of Intraductal Papillary Mucinous Neoplasia (IPMN)

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