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Role of endoscopic ultrasound and cyst fluid tumor markers in diagnosis of pancreatic cystic lesions

World Journal of Gastrointestinal Endoscopy 2022年第6期14卷 402-415页

作者： Hussein Hassan Okasha Abeer Abdellatef Shaimaa Elkholy Mohamad-Sherif Mogawer Ayman yosry Magdy Elserafy Eman Medhat Hanaa Khalaf Magdy Fouad Tamer Elbaz Ahmed Ramadan Mervat E Behiry kerolis y william Ghada Habib Mona Kaddah Haitham Abdel-Hamid Amr Abou-Elmagd Ahmed Galal Wael A Abbas Ahmed youssef Altonbary Mahmoud El-Ansary Aml E Abdou Hani Haggag Tarek Ali Abdellah Mohamed A Elfeki Heba Ahmed Faheem Hani M Khattab Mervat El-Ansary Safia Beshir Mohamed El-Nady Department of Internal Medicine and Hepatogastroenterology Kasr Al-Aini HospitalsCairo UniversityKasr Al-Aini HospitalsCairo UniversityCairo 11451Egypt Department of Endemic Diseases Cairo UniversityCairo 11451Egypt Department of Tropical Medicine and Gastroenterology Minia UniversityMinia 61511Egypt Department of Internal Medicine Kasr Al-Aini HospitalsCairo UniversityCairo 11562Egypt Department of Gastroenterology Armed forces College of MedicineCairo 11451Egypt Endoscopy and Internal Medicine Consultant at Dr/Ahmed Galal Endoscopy Center Alexandria 35516Egypt Department of Internal Medicine Faculty of MedicineAssuit UniversityAssuit 71111Egypt Department of Gastroenterology and Hepatology Mansoura UniversityMansoura 35511Egypt Department of Gastroenterology and Hepatology Theodor Bilharz Research InstituteCairo 11451Egypt Department of Microbiology and Immunology Faculty of Medicine for girls Al-Azhar UniversityCairo 11451Egypt Department of Internal Medicine Faculty of MedicineAin shams UniversityCairo 11451Egypt Department of Internal Medicine Bani-suef UniversityBani-suefBani-suef 62511Egypt Department of Pathology Faculty of MedicineCairo UniversityCairo 11451Egypt Department of Clinical Pathology Faculty of MedicineCairo UniversityCairo 11451Egypt Department of Environmental Medicine&Clinical Pathology National Research CentreCairo 11451Egypt

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 yst fluid glucose, SPINK1, amylase, and CEA levels had high statistical significance(P y 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

关键词： Pancreatic cystic neoplasm Mucinous cystic neoplasm Intraductal papillary mucinous neoplasm Mucin stain Amylase

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