Differential diagnosis of pancreatic cysts: A prospective study on the role of intra-cystic glucose concentration.
Adult
Aged
Aged, 80 and over
Carcinoembryonic Antigen
/ metabolism
Cystadenoma
/ diagnosis
Diagnosis, Differential
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Female
Glucose
/ metabolism
Humans
Male
Middle Aged
Pancreatic Cyst
/ diagnosis
Pancreatic Intraductal Neoplasms
/ diagnosis
Pancreatic Neoplasms
/ diagnosis
Prospective Studies
ROC Curve
Sensitivity and Specificity
CEA
Glucose
Intraductal papillary mucinous neoplasm
Mucinous cystadenoma
Pancreatic cysts
Serous cystadenoma
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
04
12
2019
revised:
20
06
2020
accepted:
26
06
2020
pubmed:
18
7
2020
medline:
7
8
2021
entrez:
18
7
2020
Statut:
ppublish
Résumé
The accuracy and costs of current diagnostic methods in the differential diagnosis of pancreatic cystic lesions still has ample room for improvement. The aim of the study was to confirm the diagnostic yield of intracystic glucose in the diagnosis of pancreatic cyst subtypes. We prospectively recruited all patients who underwent Endoscopic Ultrasound with Fine Needle Aspiration of pancreatic cyst at our Institution. Fifty-six patients were included in the study. We found that intracystic glucose concentration < 50 mg/dL was significantly more sensitive than a concentration of Carcinoembryonic Antigen > 192 ng/mL (93.6% vs 54.8%; p = 0.003) for the diagnosis of mucinous cysts. In terms of specificity, the two markers were not different (96% vs 100%; p = 1). Regarding the diagnosis of non-mucinous cysts, intracystic glucose concentration ≥ 50 mg/mL showed higher sensitivity than Carcinoembryonic Antigen level < 5 ng/mL (96% vs 72%) although a statistical significance could not be reached (p = 0.07). The two markers were not statistically different in terms of specificity (93.6% vs 87.1%; p = 0.62). Given its diagnostic performance and ease of measurement, intracystic glucose may replace Carcinoembryonic Antigen in the differential diagnosis of mucinous versus non-mucinous pancreatic cysts.
Sections du résumé
BACKGROUND
The accuracy and costs of current diagnostic methods in the differential diagnosis of pancreatic cystic lesions still has ample room for improvement.
AIMS
The aim of the study was to confirm the diagnostic yield of intracystic glucose in the diagnosis of pancreatic cyst subtypes.
METHODS
We prospectively recruited all patients who underwent Endoscopic Ultrasound with Fine Needle Aspiration of pancreatic cyst at our Institution.
RESULTS
Fifty-six patients were included in the study. We found that intracystic glucose concentration < 50 mg/dL was significantly more sensitive than a concentration of Carcinoembryonic Antigen > 192 ng/mL (93.6% vs 54.8%; p = 0.003) for the diagnosis of mucinous cysts. In terms of specificity, the two markers were not different (96% vs 100%; p = 1). Regarding the diagnosis of non-mucinous cysts, intracystic glucose concentration ≥ 50 mg/mL showed higher sensitivity than Carcinoembryonic Antigen level < 5 ng/mL (96% vs 72%) although a statistical significance could not be reached (p = 0.07). The two markers were not statistically different in terms of specificity (93.6% vs 87.1%; p = 0.62).
CONCLUSION
Given its diagnostic performance and ease of measurement, intracystic glucose may replace Carcinoembryonic Antigen in the differential diagnosis of mucinous versus non-mucinous pancreatic cysts.
Identifiants
pubmed: 32675041
pii: S1590-8658(20)30323-6
doi: 10.1016/j.dld.2020.06.038
pii:
doi:
Substances chimiques
Carcinoembryonic Antigen
0
Glucose
IY9XDZ35W2
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1026-1032Informations de copyright
Copyright © 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest Claudio De Angelis is consultant for Boston Scientific.