Preoperative cyst fluid analysis is useful for the differential diagnosis of cystic lesions of the pancreas

Hammel, Pascal; Lévy, Philippe; Voitot, Hélène; Levy, Michael J.; Vilgrain, Valérie; Zins, Marc; Fléjou, Jean‐François; Molas, G; Ruszniewski, Philippe; Bernadès, P

doi:10.1016/0016-5085(95)90224-4

Cited by 245 publications

(120 citation statements)

References 10 publications

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“…Previous attempts to differentiate neoplastic from nonneoplastic cysts include analysis of aspirated cyst fluid for cytology, enzymes and tumor markers (Rubin et al, 1994;Hammel et al, 1995;Sand et al, 1996;Sperti et al, 1996Sperti et al, , 1997. Thus, there is a need for a panel of markers that can accurately differentiate neoplastic from nonneoplastic pancreatic cysts.…”

Section: Discussionmentioning

confidence: 99%

Characterization of gene expression in mucinous cystic neoplasms of the pancreas using oligonucleotide microarrays

et al. 2004

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Section: Discussionmentioning

confidence: 99%

Characterization of gene expression in mucinous cystic neoplasms of the pancreas using oligonucleotide microarrays

et al. 2004

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“…Analysis of the cyst fluid for CEA, CA 19-9 and cytology may help in differentiating pancreatic cystic lesions [7][8][9][10][11] . However, data to support the role of cytology and tumor markers of the cystic fluid in differentiating benign from premalignant and malignant pancreatic cystic lesions is still limited.…”

Section: Introductionmentioning

confidence: 99%

Utility of endoscopic ultrasound, cytology and fluid carcinoembryonic antigen and CA 19-9 levels in pancreatic cystic lesions

Aljebreen

Romagnuolo²,

Perini³

et al. 2007

WJG

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AIM:To assess the diagnostic accuracy of endoscopic ultrasound (EUS), fluid tumor markers and cytology in distinguishing benign from (pre)malignant pancreatic cystic lesions. METHODS:46 consecutive patients, referred to a gastroenterologist and surgeon for a symptomatic or incidental pancreatic cyst, were reviewed. EUS, cytology, and carcinoembryonic antigen (CEA) and carbohydrate antigen (CA 19-9) levels were compared with the final diagnosis, based on surgical pathology and/or imaging follow-up of at least 12 mo. Cysts were classified as benign (pseudocyst, serous cystadenoma) or malignant/ pre-malignant (mucinous cystic neoplasm). Receiveroperator characteristics (ROC) curve analysis was performed. RESULTS:The mean age was 56 years; 29% were male and median cyst diameter was 3 cm. Final outcome was obtained in 41 (89%) patients. Twenty-three (56%) of these 41 had surgical pathology. Twenty-three (56%) had benign lesions and 18 (44%) had malignant/premalignant lesions. Sensitivity, specificity and positive and negative predictive value of EUS alone to distinguish benign from malignant/premalignant pancreatic cystic lesions were 50%, 56%, 36% and 54% and for cytology were 71%, 96%, 92% and 85%, respectively. The corresponding values for the ROC-derived ideal cutoffs were 75%, 90%, 75%, 90% for CA 19-9 (> 37 U/mL) and 70%, 85%, 79% and 78% for CEA (> 3.1 ng/mL). Subgroup analysis of those with surgical pathology yielded almost identical performance and cutoffs.CONCLUSION: Cytology and cyst fluid tumor marker analysis is a very useful tool in distinguishing benign from (pre)malignant pancreatic cystic lesions.

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“…van der Waaij et al [14] found that an amylase concentration below 250 U/L effectively ruled out pseudocyst. In addition, it has been reported that cyst fluid CA 19-9 level greater than 50 000 U/mL had a sensitivity of 75% and a specificity of 90% for distinguishing mucinous tumors from other cystic lesions [15] . Furthermore, a recent series [16] revealed that cyst fluid CEA greater than 800 ng/mL had a sensitivity of 42.9% and a specificity of 95.2% for diagnosing pancreatic MCNs.…”

Section: Discussionmentioning

confidence: 99%

Large mucinous cystic neoplasm of the pancreas associated with pregnancy

Ikuta¹,

Aihara²,

Yasui³

et al. 2008

WJG

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Mucinous cystic neoplasms (MCNs) of the pancreas occur mostly in females and are potentially sex hormone-sensitive. However, a MCN occurring during pregnancy is quite rare. A 30-year-old woman in the tenth week of pregnancy was referred to us because of a rapid increase in left hypochondrial distending pain. On ultrasound, the patient had a large intra-abdominal cystic lesion. She was thereafter diagnosed with missed abortion and a computed tomography scan showed that the lesion was a cystic tumor 18 cm in diameter originating from the pancreatic tail. The patient subsequently underwent tumor resection with distal pancreatectomy, sparing the spleen. Histopathological analysis of the specimen revealed a pancreatic MCN with moderate dysplasia. Immunohistochemically, the tumor was positive for both estrogen and progesterone receptors. To our knowledge, this is the first reported case of pancreatic MCN with moderate dysplasia in association with pregnancy. Our case strongly indicates that pancreatic MCN is female-hormone dependent.

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Preoperative cyst fluid analysis is useful for the differential diagnosis of cystic lesions of the pancreas

Cited by 245 publications

References 10 publications

Characterization of gene expression in mucinous cystic neoplasms of the pancreas using oligonucleotide microarrays

Characterization of gene expression in mucinous cystic neoplasms of the pancreas using oligonucleotide microarrays

Utility of endoscopic ultrasound, cytology and fluid carcinoembryonic antigen and CA 19-9 levels in pancreatic cystic lesions

Large mucinous cystic neoplasm of the pancreas associated with pregnancy

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