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The Combination of Cyst Fluid Carcinoembryonic Antigen, Cytology and Viscosity Increases the Diagnostic Accuracy of Mucinous Pancreatic Cysts.
Gut Liver. 2017 Mar 15; 11(2):283-289.GL

Abstract

Background/Aims

The objective of this study was to investigate the value of cyst fluid carcinoembryonic antigen (CEA) in combination with cytology and viscosity for the differential diagnosis of pancreatic cysts.

Methods

We retrospectively reviewed our data for patients who underwent endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and cyst fluid analysis. We investigated the sensitivity, specificity and accuracy of the combination of cyst fluid CEA, cytology and viscosity testing.

Results

A total of 177 patients underwent EUS-FNA and cyst fluid analysis. Of these, 48 subjects were histologically and clinically confirmed to have pancreatic cysts and were therefore included in the analysis. Receiver operator curve analysis demonstrated that the optimal cutoff value of cyst fluid CEA for differentiating mucinous versus nonmucinous cystic lesions was 48.6 ng/mL. The accuracy of cyst fluid CEA (39/48, 81.3%) was greater than the accuracy of cytology (23/45, 51.1%) or the string sign (33/47, 70.2%). Cyst fluid CEA in combination with cytology and string sign assessment exhibited the highest accuracy (45/48, 93.8%).

Conclusions

Cyst fluid CEA was the most useful single test for identifying mucinous pancreatic cysts. The addition of cytology and string sign assessment to cyst fluid CEA increased the overall accuracy for the diagnosis of mucinous pancreatic cysts.

Authors+Show Affiliations

Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Gastroenterology, Department of Internal Medicine, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea.Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

27609484

Citation

Oh, Se Hun, et al. "The Combination of Cyst Fluid Carcinoembryonic Antigen, Cytology and Viscosity Increases the Diagnostic Accuracy of Mucinous Pancreatic Cysts." Gut and Liver, vol. 11, no. 2, 2017, pp. 283-289.
Oh SH, Lee JK, Lee KT, et al. The Combination of Cyst Fluid Carcinoembryonic Antigen, Cytology and Viscosity Increases the Diagnostic Accuracy of Mucinous Pancreatic Cysts. Gut Liver. 2017;11(2):283-289.
Oh, S. H., Lee, J. K., Lee, K. T., Lee, K. H., Woo, Y. S., & Noh, D. H. (2017). The Combination of Cyst Fluid Carcinoembryonic Antigen, Cytology and Viscosity Increases the Diagnostic Accuracy of Mucinous Pancreatic Cysts. Gut and Liver, 11(2), 283-289. https://doi.org/10.5009/gnl15650
Oh SH, et al. The Combination of Cyst Fluid Carcinoembryonic Antigen, Cytology and Viscosity Increases the Diagnostic Accuracy of Mucinous Pancreatic Cysts. Gut Liver. 2017 Mar 15;11(2):283-289. PubMed PMID: 27609484.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Combination of Cyst Fluid Carcinoembryonic Antigen, Cytology and Viscosity Increases the Diagnostic Accuracy of Mucinous Pancreatic Cysts. AU - Oh,Se Hun, AU - Lee,Jong Kyun, AU - Lee,Kyu Taek, AU - Lee,Kwang Hyuck, AU - Woo,Young Sik, AU - Noh,Dong Hyo, PY - 2015/12/26/received PY - 2016/04/14/revised PY - 2016/04/14/accepted PY - 2016/9/10/pubmed PY - 2017/10/12/medline PY - 2016/9/10/entrez KW - Cyst fluid analysis KW - Cyst fluid carcinoembryonic antigen KW - Pancreatic cyst SP - 283 EP - 289 JF - Gut and liver JO - Gut Liver VL - 11 IS - 2 N2 - Background/Aims: The objective of this study was to investigate the value of cyst fluid carcinoembryonic antigen (CEA) in combination with cytology and viscosity for the differential diagnosis of pancreatic cysts. Methods: We retrospectively reviewed our data for patients who underwent endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and cyst fluid analysis. We investigated the sensitivity, specificity and accuracy of the combination of cyst fluid CEA, cytology and viscosity testing. Results: A total of 177 patients underwent EUS-FNA and cyst fluid analysis. Of these, 48 subjects were histologically and clinically confirmed to have pancreatic cysts and were therefore included in the analysis. Receiver operator curve analysis demonstrated that the optimal cutoff value of cyst fluid CEA for differentiating mucinous versus nonmucinous cystic lesions was 48.6 ng/mL. The accuracy of cyst fluid CEA (39/48, 81.3%) was greater than the accuracy of cytology (23/45, 51.1%) or the string sign (33/47, 70.2%). Cyst fluid CEA in combination with cytology and string sign assessment exhibited the highest accuracy (45/48, 93.8%). Conclusions: Cyst fluid CEA was the most useful single test for identifying mucinous pancreatic cysts. The addition of cytology and string sign assessment to cyst fluid CEA increased the overall accuracy for the diagnosis of mucinous pancreatic cysts. SN - 2005-1212 UR - https://www.unboundmedicine.com/medline/citation/27609484/The_Combination_of_Cyst_Fluid_Carcinoembryonic_Antigen_Cytology_and_Viscosity_Increases_the_Diagnostic_Accuracy_of_Mucinous_Pancreatic_Cysts_ L2 - http://www.gutnliver.org/journal/view.html?doi=10.5009/gnl15650 DB - PRIME DP - Unbound Medicine ER -