PMID- 17663510
OWN - NLM
STAT- MEDLINE
DCOM- 20071107
LR  - 20190430
IS  - 1007-9327 (Print)
IS  - 2219-2840 (Electronic)
IS  - 1007-9327 (Linking)
VI  - 13
IP  - 29
DP  - 2007 Aug 7
TI  - Utility of endoscopic ultrasound, cytology and fluid carcinoembryonic antigen and 
      CA 19-9 levels in pancreatic cystic lesions.
PG  - 3962-6
AB  - AIM: To assess the diagnostic accuracy of endoscopic ultrasound (EUS), fluid 
      tumor markers and cytology in distinguishing benign from (pre)malignant 
      pancreatic cystic lesions. METHODS: 46 consecutive patients, referred to a 
      gastroenterologist and surgeon for a symptomatic or incidental pancreatic cyst, 
      were reviewed. EUS, cytology, and carcinoembryonic antigen (CEA) and carbohydrate 
      antigen (CA 19-9) levels were compared with the final diagnosis, based on 
      surgical pathology and/or imaging follow-up of at least 12 mo. Cysts were 
      classified as benign (pseudocyst, serous cystadenoma) or malignant/pre-malignant 
      (mucinous cystic neoplasm). Receiver-operator characteristics (ROC) curve 
      analysis was performed. RESULTS: The mean age was 56 years; 29% were male and 
      median cyst diameter was 3 cm. Final outcome was obtained in 41 (89%) patients. 
      Twenty-three (56%) of these 41 had surgical pathology. Twenty-three (56%) had 
      benign lesions and 18 (44%) had malignant/pre-malignant lesions. Sensitivity, 
      specificity and positive and negative predictive value of EUS alone to 
      distinguish benign from malignant/premalignant pancreatic cystic lesions were 
      50%, 56%, 36% and 54% and for cytology were 71%, 96%, 92% and 85%, respectively. 
      The corresponding values for the ROC-derived ideal cutoffs were 75%, 90%, 75%, 
      90% for CA 19-9 (> 37 U/mL) and 70%, 85%, 79% and 78% for CEA (> 3.1 ng/mL). 
      Subgroup analysis of those with surgical pathology yielded almost identical 
      performance and cutoffs. CONCLUSION: Cytology and cyst fluid tumor marker 
      analysis is a very useful tool in distinguishing benign from (pre)malignant 
      pancreatic cystic lesions.
FAU - Aljebreen, Abdulrahman M
AU  - Aljebreen AM
AD  - Director of Clinical Research, Medical University of South Carolina (MUSC), 
      Digestive Disease Center, 96 Jonathon Lucas St, CSB #210, PO Box 250 327 
      Charleston, SC 29425 USA. romagnuo@musc.edu
FAU - Romagnuolo, Joseph
AU  - Romagnuolo J
FAU - Perini, Rafael
AU  - Perini R
FAU - Sutherland, Francis
AU  - Sutherland F
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - World J Gastroenterol
JT  - World journal of gastroenterology
JID - 100883448
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (CA-19-9 Antigen)
RN  - 0 (Carcinoembryonic Antigen)
SB  - IM
MH  - Aged
MH  - Biomarkers, Tumor
MH  - Biopsy, Fine-Needle
MH  - CA-19-9 Antigen/*biosynthesis
MH  - Carcinoembryonic Antigen/*biosynthesis
MH  - Endoscopy/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pancreas/pathology
MH  - ROC Curve
MH  - Sensitivity and Specificity
MH  - Treatment Outcome
MH  - Ultrasonography/*methods
PMC - PMC4171168
EDAT- 2007/08/01 09:00
MHDA- 2007/11/08 09:00
PMCR- 2007/08/07
CRDT- 2007/08/01 09:00
PHST- 2007/08/01 09:00 [pubmed]
PHST- 2007/11/08 09:00 [medline]
PHST- 2007/08/01 09:00 [entrez]
PHST- 2007/08/07 00:00 [pmc-release]
AID - 10.3748/wjg.v13.i29.3962 [doi]
PST - ppublish
SO  - World J Gastroenterol. 2007 Aug 7;13(29):3962-6. doi: 10.3748/wjg.v13.i29.3962.