Role of endoscopic ultrasound and cyst fluid tumor markers in diagnosis of pancreatic cystic lesions
作者机构：Department of Internal Medicine and HepatogastroenterologyKasr Al-Aini HospitalsCairo UniversityKasr Al-Aini HospitalsCairo UniversityCairo 11451Egypt Department of Endemic DiseasesCairo UniversityCairo 11451Egypt Department of Tropical Medicine and GastroenterologyMinia UniversityMinia 61511Egypt Department of Internal MedicineKasr Al-Aini HospitalsCairo UniversityCairo 11562Egypt Department of GastroenterologyArmed forces College of MedicineCairo 11451Egypt Endoscopy and Internal Medicine Consultant at Dr/Ahmed Galal Endoscopy CenterAlexandria 35516Egypt Department of Internal MedicineFaculty of MedicineAssuit UniversityAssuit 71111Egypt Department of Gastroenterology and HepatologyMansoura UniversityMansoura 35511Egypt Department of Gastroenterology and HepatologyTheodor Bilharz Research InstituteCairo 11451Egypt Department of Microbiology and ImmunologyFaculty of Medicine for girls Al-Azhar UniversityCairo 11451Egypt Department of Internal MedicineFaculty of MedicineAin shams UniversityCairo 11451Egypt Department of Internal MedicineBani-suef UniversityBani-suefBani-suef 62511Egypt Department of PathologyFaculty of MedicineCairo UniversityCairo 11451Egypt Department of Clinical PathologyFaculty of MedicineCairo UniversityCairo 11451Egypt Department of Environmental Medicine&Clinical PathologyNational Research CentreCairo 11451Egypt
出 版 物：《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志（英文版）（电子版）)
年 卷 期：2022年第14卷第6期
页 面：402-415页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Pancreatic cystic neoplasm Mucinous cystic neoplasm Intraductal papillary mucinous neoplasm Mucin stain Amylase
摘 要：BACKGROUND Pancreatic cystic lesions(PCLs) are common in clinical practice. The accurate classification and diagnosis of these lesions are crucial to avoid unnecessary treatment of benign lesions and missed opportunities for early treatment of potentially malignant *** To evaluate the role of cyst fluid analysis of different tumor markers such as cancer antigens [e.g., cancer antigen(CA)19-9, CA72-4], carcinoembryonic antigen(CEA), serine protease inhibitor Kazal-type 1(SPINK1), interleukin 1 beta(IL1-β), vascular endothelial growth factor A(VEGF-A), and prostaglandin E2(PGE2)], amylase, and mucin stain in diagnosing pancreatic cysts and differentiating malignant from benign *** This study included 76 patients diagnosed with PCLs using different imaging modalities. All patients underwent endoscopic ultrasound(EUS) and EUS-fine needle aspiration(EUS-FNA) for characterization and sampling of different *** The mean age of studied patients was 47.4 ± 11.4 years, with a slight female predominance(59.2%). Mucin stain showed high statistical significance in predicting malignancy with a sensitivity of 87.1% and specificity of 95.56%. It also showed a positive predictive value and negative predictive value of 93.1% and 91.49%, respectively(P 0.001). We found that positive mucin stain, cyst fluid glucose, SPINK1, amylase, and CEA levels had high statistical significance(P 0.0001). In contrast, IL-1β, CA 72-4, VEGF-A, VEGFR2, and PGE2 did not show any statistical significance. Univariate regression analysis for prediction of malignancy in PCLs showed a statistically significant positive correlation with mural nodules, lymph nodes, cyst diameter, mucin stain, and cyst fluid CEA. Meanwhile, logistic multivariable regression analysis proved that mural nodules, mucin stain, and SPINK1 were independent predictors of malignancy in cystic pancreatic *** EUS examination of cyst morphology with cytopathological analysis and cyst fluid ana
维普期刊数据库