Cyst Fluid Carcinoembryonic Antigen Level Difference between Mucinous Cystic Neoplasms and Intraductal Papillary Mucinous Neoplasms
Background/Aims The role of cyst fluid carcinoembryonic antigen (CEA) level in differentiating mucinous pancreatic cystic lesions (PCLs) is controversial. We investigated the role of cyst fluid CEA in differentiating low-risk (LR)-intraductal papillary mucinous neoplasms (IPMNs) from high-risk (HR)-...
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| Format: | Article |
| Language: | English |
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Korean Society of Gastrointestinal Endoscopy
2021-01-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2020-083.pdf |
| _version_ | 1797642894854586368 |
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| author | Ibrahim Hakkı Köker Nurcan Ünver Fatma Ümit Malya Ömer Uysal Elmas Biberci Keskin Hakan Şentürk |
| author_facet | Ibrahim Hakkı Köker Nurcan Ünver Fatma Ümit Malya Ömer Uysal Elmas Biberci Keskin Hakan Şentürk |
| author_sort | Ibrahim Hakkı Köker |
| collection | DOAJ |
| description | Background/Aims The role of cyst fluid carcinoembryonic antigen (CEA) level in differentiating mucinous pancreatic cystic lesions (PCLs) is controversial. We investigated the role of cyst fluid CEA in differentiating low-risk (LR)-intraductal papillary mucinous neoplasms (IPMNs) from high-risk (HR)-IPMNs and LR-mucinous cystic neoplasms (MCNs). Methods This was a retrospective study of 466 patients with PCLs who underwent endoscopic ultrasound-guided fine-needleaspiration over a 7-year period. On histology, low-grade dysplasia and intermediate-grade dysplasia were considered LR, whereas high-grade dysplasia and invasive carcinoma were considered HR. Results Data on cyst fluid CEA levels were available for 50/102 mucinous PCLs with definitive diagnoses. The median CEA (range) levels were significantly higher in HR cysts than in LR cysts (2,624 [0.5–266,510] ng/mL vs. 100 [16.8–53,445]ng/mL, p=0.0012). The area under the receiver operating characteristic curve (AUROC) was 0.930 (95% confidence interval [CI], 0.5–0.8; p<0.001) for differentiating LR-IPMNs from LR-MCNs. The AUROC was 0.921 (95% CI, 0.823–1.000; p<0.001) for differentiating LR-IPMNs from HR-IPMNs. Both had a CEA cutoff level of >100ng/mL, with a negative predictive value (NPV) of 100%. Conclusions Cyst fluid CEA levels significantly vary between LR-IPMNs, LR-MCNs, and HR-IPMNs. A CEA cutoff level of >100ng/mL had a 100% NPV in differentiating LR-IPMNs from LR-MCNs and HR-IPMNs. |
| first_indexed | 2024-03-11T14:07:46Z |
| format | Article |
| id | doaj.art-f383edc5f6684ddca32caf082508c8f2 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-11T14:07:46Z |
| publishDate | 2021-01-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-f383edc5f6684ddca32caf082508c8f22023-11-02T01:39:26ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432021-01-0154111312110.5946/ce.2020.0837447Cyst Fluid Carcinoembryonic Antigen Level Difference between Mucinous Cystic Neoplasms and Intraductal Papillary Mucinous NeoplasmsIbrahim Hakkı Köker0Nurcan Ünver1Fatma Ümit Malya2Ömer Uysal3Elmas Biberci Keskin4Hakan Şentürk5 Department of Gastroenterology, Bezmialem Vakif University Medicine Faculty, Istanbul, Turkey Department of Pathology, Bezmialem Vakif University Medicine Faculty, Istanbul, Turkey Department of General Surgery, Bezmialem Vakif University Medicine Faculty, Istanbul, Turkey Department of Biostatistics, Bezmialem Vakif University Medicine Faculty, Istanbul, Turkey Department of Gastroenterology, Bezmialem Vakif University Medicine Faculty, Istanbul, Turkey Department of Gastroenterology, Bezmialem Vakif University Medicine Faculty, Istanbul, TurkeyBackground/Aims The role of cyst fluid carcinoembryonic antigen (CEA) level in differentiating mucinous pancreatic cystic lesions (PCLs) is controversial. We investigated the role of cyst fluid CEA in differentiating low-risk (LR)-intraductal papillary mucinous neoplasms (IPMNs) from high-risk (HR)-IPMNs and LR-mucinous cystic neoplasms (MCNs). Methods This was a retrospective study of 466 patients with PCLs who underwent endoscopic ultrasound-guided fine-needleaspiration over a 7-year period. On histology, low-grade dysplasia and intermediate-grade dysplasia were considered LR, whereas high-grade dysplasia and invasive carcinoma were considered HR. Results Data on cyst fluid CEA levels were available for 50/102 mucinous PCLs with definitive diagnoses. The median CEA (range) levels were significantly higher in HR cysts than in LR cysts (2,624 [0.5–266,510] ng/mL vs. 100 [16.8–53,445]ng/mL, p=0.0012). The area under the receiver operating characteristic curve (AUROC) was 0.930 (95% confidence interval [CI], 0.5–0.8; p<0.001) for differentiating LR-IPMNs from LR-MCNs. The AUROC was 0.921 (95% CI, 0.823–1.000; p<0.001) for differentiating LR-IPMNs from HR-IPMNs. Both had a CEA cutoff level of >100ng/mL, with a negative predictive value (NPV) of 100%. Conclusions Cyst fluid CEA levels significantly vary between LR-IPMNs, LR-MCNs, and HR-IPMNs. A CEA cutoff level of >100ng/mL had a 100% NPV in differentiating LR-IPMNs from LR-MCNs and HR-IPMNs.http://www.e-ce.org/upload/pdf/ce-2020-083.pdfcarcinoembryonic antigenmalignancypancreatic cysts |
| spellingShingle | Ibrahim Hakkı Köker Nurcan Ünver Fatma Ümit Malya Ömer Uysal Elmas Biberci Keskin Hakan Şentürk Cyst Fluid Carcinoembryonic Antigen Level Difference between Mucinous Cystic Neoplasms and Intraductal Papillary Mucinous Neoplasms Clinical Endoscopy carcinoembryonic antigen malignancy pancreatic cysts |
| title | Cyst Fluid Carcinoembryonic Antigen Level Difference between Mucinous Cystic Neoplasms and Intraductal Papillary Mucinous Neoplasms |
| title_full | Cyst Fluid Carcinoembryonic Antigen Level Difference between Mucinous Cystic Neoplasms and Intraductal Papillary Mucinous Neoplasms |
| title_fullStr | Cyst Fluid Carcinoembryonic Antigen Level Difference between Mucinous Cystic Neoplasms and Intraductal Papillary Mucinous Neoplasms |
| title_full_unstemmed | Cyst Fluid Carcinoembryonic Antigen Level Difference between Mucinous Cystic Neoplasms and Intraductal Papillary Mucinous Neoplasms |
| title_short | Cyst Fluid Carcinoembryonic Antigen Level Difference between Mucinous Cystic Neoplasms and Intraductal Papillary Mucinous Neoplasms |
| title_sort | cyst fluid carcinoembryonic antigen level difference between mucinous cystic neoplasms and intraductal papillary mucinous neoplasms |
| topic | carcinoembryonic antigen malignancy pancreatic cysts |
| url | http://www.e-ce.org/upload/pdf/ce-2020-083.pdf |
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