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Cyst fluid glucose: An alternative to carcinoembryonic antigen for pancreatic mucinous cysts

Cyst fluid glucose: An alternative to carcinoembryonic antigen for pancreatic mucinous cysts

作     者:César Vivian Lopes 

作者机构:Department of Gastroenterology and Digestive Endoscopy Santa Casa Hospital 

出 版 物:《World Journal of Gastroenterology》 (世界胃肠病学杂志(英文版))

年 卷 期:2019年第25卷第19期

页      面:2271-2278页

核心收录:

学科分类:1002[医学-临床医学] 10[医学] 

主  题:Carcinoembryonic antigen Differential diagnosis Fine-needle biopsy Glucose Pancreatic cyst Tumor marker 

摘      要:Pancreatic cystic lesions(PCLs) have been increasingly recognized in clinical practice. Although inflammatory cysts(pseudocysts) are the most common PCLs detected by cross-sectional imaging modalities in symptomatic patients in a setting of acute or chronic pancreatitis, incidental pancreatic cysts with no symptoms or history of pancreatitis are usually neoplastic cysts. For these lesions,it is imperative to identify mucinous cysts(intraductal papillary mucinous neoplasms and mucinous cystic neoplasms) due to the risk of their progression to malignancy. However, no single imaging modality alone is sufficient for a definitive diagnosis of all PCLs. The cyst fluid obtained by endoscopic ultrasound-guided fine needle aspiration provides additional information for the differential diagnosis of PCLs. Current recommendations suggest sending cyst fluid for cytology evaluation and measurement of carcinoembryonic antigen(CEA) levels. Unfortunately, the sensitivity of cytology is greatly limited, and cyst fluid CEA has demonstrated insufficient accuracy as a predictor of mucinous cysts. More recently, cyst fluid glucose has emerged as an alternative to CEA for distinguishing between mucinous and nonmucinous lesions. Herein, the clinical utility of cyst fluid glucose and CEA for the differential diagnosis of PCLs was evaluated.

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