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Cyst fluid carcinoembryonic antigen is an accurate diagnostic marker of pancreatic mucinous cysts.
Pancreas. 2011 Oct; 40(7):1024-8.P

Abstract

OBJECTIVES

Endoscopic ultrasound (EUS) may offer a diagnostic tool through the combination of imaging and guided fine-needle aspiration of pancreatic cysts. The purpose of this investigation was to determine the most accurate test for differentiating mucinous from nonmucinous cysts.

METHODS

The results of EUS imaging, cytology, and cyst fluid biochemical markers were prospectively collected and compared in a large single-center study (776 patients) using histology or malignant cytology as the final diagnostic standard in 198 patients.

RESULTS

The mean cyst fluid carcinoembryonic antigen (CEA) was greater in mucinous cysts (4703.0 ng/mL) compared with nonmucinous cysts (25.8 ng/mL) (P = 0.008). When using the optimal cutoff value of 109.9 ng/mL, the CEA was more accurate (86%, receiver operating characteristic area = 0.928) than EUS imaging (48%) and cytology (58%) in predicting a mucinous cyst (P < 0.0001). Malignant cysts had a mean cyst fluid CEA value (2558.2 ng/mL) similar to benign cysts (4700.2 ng/mL). Cytology (75%) more accurately diagnosed malignant cysts than EUS (66%) and CEA (62%) (P < 0.05).

CONCLUSIONS

Cyst fluid CEA concentration provides a highly accurate test for the diagnosis of a mucinous cyst, but does not distinguish benign from malignant cysts. Cytology is the most accurate test for the diagnosis of a malignant cyst.

Authors+Show Affiliations

Gastrointestinal Unit, Massachusetts General Hospital, Boston, MA 02116, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21775920

Citation

Cizginer, Sevdenur, et al. "Cyst Fluid Carcinoembryonic Antigen Is an Accurate Diagnostic Marker of Pancreatic Mucinous Cysts." Pancreas, vol. 40, no. 7, 2011, pp. 1024-8.
Cizginer S, Turner BG, Turner B, et al. Cyst fluid carcinoembryonic antigen is an accurate diagnostic marker of pancreatic mucinous cysts. Pancreas. 2011;40(7):1024-8.
Cizginer, S., Turner, B. G., Turner, B., Bilge, A. R., Karaca, C., Pitman, M. B., & Brugge, W. R. (2011). Cyst fluid carcinoembryonic antigen is an accurate diagnostic marker of pancreatic mucinous cysts. Pancreas, 40(7), 1024-8. https://doi.org/10.1097/MPA.0b013e31821bd62f
Cizginer S, et al. Cyst Fluid Carcinoembryonic Antigen Is an Accurate Diagnostic Marker of Pancreatic Mucinous Cysts. Pancreas. 2011;40(7):1024-8. PubMed PMID: 21775920.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cyst fluid carcinoembryonic antigen is an accurate diagnostic marker of pancreatic mucinous cysts. AU - Cizginer,Sevdenur, AU - Turner,Brian G, AU - Turner,Brian, AU - Bilge,A Reyyan, AU - Karaca,Cetin, AU - Pitman,Martha B, AU - Brugge,William R, PY - 2011/7/22/entrez PY - 2011/7/22/pubmed PY - 2012/1/13/medline SP - 1024 EP - 8 JF - Pancreas JO - Pancreas VL - 40 IS - 7 N2 - OBJECTIVES: Endoscopic ultrasound (EUS) may offer a diagnostic tool through the combination of imaging and guided fine-needle aspiration of pancreatic cysts. The purpose of this investigation was to determine the most accurate test for differentiating mucinous from nonmucinous cysts. METHODS: The results of EUS imaging, cytology, and cyst fluid biochemical markers were prospectively collected and compared in a large single-center study (776 patients) using histology or malignant cytology as the final diagnostic standard in 198 patients. RESULTS: The mean cyst fluid carcinoembryonic antigen (CEA) was greater in mucinous cysts (4703.0 ng/mL) compared with nonmucinous cysts (25.8 ng/mL) (P = 0.008). When using the optimal cutoff value of 109.9 ng/mL, the CEA was more accurate (86%, receiver operating characteristic area = 0.928) than EUS imaging (48%) and cytology (58%) in predicting a mucinous cyst (P < 0.0001). Malignant cysts had a mean cyst fluid CEA value (2558.2 ng/mL) similar to benign cysts (4700.2 ng/mL). Cytology (75%) more accurately diagnosed malignant cysts than EUS (66%) and CEA (62%) (P < 0.05). CONCLUSIONS: Cyst fluid CEA concentration provides a highly accurate test for the diagnosis of a mucinous cyst, but does not distinguish benign from malignant cysts. Cytology is the most accurate test for the diagnosis of a malignant cyst. SN - 1536-4828 UR - https://www.unboundmedicine.com/medline/citation/21775920/Cyst_fluid_carcinoembryonic_antigen_is_an_accurate_diagnostic_marker_of_pancreatic_mucinous_cysts_ DB - PRIME DP - Unbound Medicine ER -