Rapid diagnosis of mucinous cystic pancreatic lesions by on-site cyst fluid glucometry

Lariño‐Noia, José; Mejuto, Rafael; Oria, Ines; Iglesia‐García, Daniel de la; Villaverde, Augusto; Voces, Alba; Pizzala, Juan E.; Iglesias‐García, Julio; Urgiles, Dalila; Marcolongo, Mariano; Mazza, Oscar; Domínguez‐Muñoz, Enrique

doi:10.1007/s00464-021-08532-9

Cited by 5 publications

(8 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…24 In addition, our study validates glucometry glucose measurement against reference laboratory biochemical analysis (considered as the gold standard test) when drawn from a PCL. Consistent with the study by Noia et al, 13 our analysis also demonstrated an excellent ICC and a comparable sensitivity and specificity calculated by both methods.…”

Section: Discussionsupporting

confidence: 92%

“…First, we evaluated the specificity, sensitivity, and diagnostic accuracy of glucose using an intermediate glucose cutoff level of 60 mg/dL, since previous studies have used a glucose cutoff level in the range of 50–73 mg/dL. 8 – 13 Second, we used the CART method in order to assess the optimal glucose cutoff level for identifying mucinous cysts. The results are presented in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“… 8 – 12 A bed-side glucometer is a point-of care, immediate, simple, and cheap method which requires a small volume of PCF [2–4 microliters (μL)] compared to the volume required for the standard biochemical analysis. 9 , 13 Glucose levels measured using glucometry were previously validated in several studies, suggesting glucometry as a feasible, accurate, and reproducible method for the characterization of PCLs. 10 , 13 …”

Section: Introductionmentioning

confidence: 99%

“… 9 , 13 Glucose levels measured using glucometry were previously validated in several studies, suggesting glucometry as a feasible, accurate, and reproducible method for the characterization of PCLs. 10 , 13 …”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10][11][12] A bed-side glucometer is a point-of care, immediate, simple, and cheap method which requires a small volume of PCF [2-4 microliters (μL)] compared to the volume required for the standard biochemical analysis. 9,13 Glucose levels measured using glucometry were previously validated in several studies, suggesting glucometry as a feasible, accurate, and reproducible method for the characterization of PCLs. 10,13 The aim of this study was to identify the optimal glucose cutoff level; to evaluate glucose specificity, sensitivity, and diagnostic accuracy for mucinous cysts, in comparison to CEA levels; and to re-validate the diagnostic accuracy of on-site glucometry against a reference laboratory procedure.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Pancreatic cyst fluid glucose: a rapid on-site diagnostic test for mucinous cysts

Zamir

Yovel

Scapa

et al. 2022

Therap Adv Gastroenterol

View full text Add to dashboard Cite

Background: Pancreatic cystic fluid (PCF) analysis is frequently used for cyst diagnosis with carcinoembryonic antigen (CEA) being the most accepted biomarker. Low glucose levels in PCF were previously suggested as a marker for mucinous cysts. A bed-side glucometer is a point-of care, immediate, simple, and cheap method which requires a small volume of PCF. Objectives: The aim of our study was to identify the optimal glucose cut-off level for identifying mucinous cysts, evaluate the diagnostic accuracy of glucose compared to CEA, and validate glucometry against reference laboratory biochemical analysis. Design: A single-center prospective cohort study. Methods: Consecutive patients aged 18 and older, who underwent pancreatic cyst evaluation, at the Tel Aviv Medical Center between 2016 and 2021 were analyzed. Cyst type was defined based on clinical, laboratory, and radiologic findings. Glucose was measured using laboratory biochemical analysis and two glucometers. Receiver operating characteristic analysis derived sensitivity, specificity, and accuracy were calculated and McNemar test was used to compare between methods. Results: One hundred and one PCF samples were evaluated. The areas under the receiver operating characteristics curve for identifying mucinous cysts using glucometer, glucose laboratory, and their combination were 0.88 ( p < 0.001), 0.92 ( p < 0.001), and 0.93 ( p < 0.001), respectively. A glucose level of 87 mg/dL was identified as the optimal laboratory glucose threshold value to detect mucinous cyst with a sensitivity of 90.9%, specificity of 83.3%, and accuracy of 89.3, higher in comparison to cyst fluid CEA. Furthermore, PCF glucose levels had the strongest association with mucinous cysts. Conclusion: Our findings suggest that PCF glucose level is more accurate than CEA for the diagnosis of mucinous cysts. Glucometry glucose level assessment demonstrated an excellent correlation with laboratory glucose measurements and may become a useful diagnostic test.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Pancreatic cyst fluid glucose: a rapid on-site diagnostic test for mucinous cysts

Zamir

Yovel

Scapa

et al. 2022

Therap Adv Gastroenterol

View full text Add to dashboard Cite

show abstract

Pancreatic Cyst Fluid Analysis

Siddappa

Park

2023

Gastrointestinal Endoscopy Clinics of North America

View full text Add to dashboard Cite

Comparative Performance of Endoscopic Ultrasound-Based Techniques in Patients With Pancreatic Cystic Lesions: A Network Meta-Analysis

Wang

Pan

et al. 2022

Am J Gastroenterol

View full text Add to dashboard Cite

INTRODUCTION:Evidence on the comparative diagnostic performance of endoscopic ultrasound (EUS)-based techniques for pancreatic cystic lesions (PCLs) is limited. This network meta-analysis comprehensively compared EUS-based techniques for PCL diagnosis.METHODS:A comprehensive literature search was performed for all comparative studies assessing the accuracy of 2 or more modalities for PCL diagnosis. The primary outcome was the diagnostic efficacy for mucinous PCLs. Secondary outcomes were the diagnostic efficacy for malignant PCLs, diagnostic success rate, and adverse event rate. A network meta-analysis was conducted using the ANOVA model to assess the diagnostic accuracy of each index.RESULTS:Forty studies comprising 3,641 patients were identified. The network ranking of the superiority index for EUS-guided needle-based confocal laser endomicroscopy (EUS-nCLE) and EUS-guided through-the-needle biopsy (EUS-TTNB) were significantly higher than other techniques for differentiating mucinous PCLs; besides, EUS-TTNB was also the optimal technique in identifying malignant PCLs. The evidence was inadequate for EUS-nCLE diagnosing malignant PCLs and contrast-enhanced harmonic EUS diagnosing both mucinous and malignant PCLs. Glucose showed a high sensitivity but low specificity, and molecular analysis (KRAS, GNAS, and KRAS + GNAS mutations) showed a high specificity but low sensitivity for diagnosing mucinous PCLs. Satisfactory results were not obtained during the evaluation of the efficiency of pancreatic cyst fluid (PCF) biomarkers in detecting malignant PCLs.DISCUSSION:For centers with relevant expertise and facilities, EUS-TTNB and EUS-nCLE were better choices for the diagnosis of PCLs. Further studies are urgently required for further improving PCF biomarkers and validating the diagnostic performance of the index techniques.

show abstract

Rapid diagnosis of mucinous cystic pancreatic lesions by on-site cyst fluid glucometry

Cited by 5 publications

References 18 publications

Pancreatic cyst fluid glucose: a rapid on-site diagnostic test for mucinous cysts

Pancreatic cyst fluid glucose: a rapid on-site diagnostic test for mucinous cysts

Pancreatic Cyst Fluid Analysis

Comparative Performance of Endoscopic Ultrasound-Based Techniques in Patients With Pancreatic Cystic Lesions: A Network Meta-Analysis

Contact Info

Product

Resources

About