Role of endoscopic ultrasound and cyst fluid tumor markers in diagnosis of pancreatic cystic lesions.
| Title: | Role of endoscopic ultrasound and cyst fluid tumor markers in diagnosis of pancreatic cystic lesions. |
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| Authors: | Okasha HH; Department of Internal Medicine and Hepatogastroenterology, Kasr Al-Aini Hospitals, Cairo University, Kasr Al-Aini Hospitals, Cairo University, Cairo 11451, Egypt.; Abdellatef A; Department of Internal Medicine and Hepatogastroenterology, Kasr Al-Aini Hospitals, Cairo University, Kasr Al-Aini Hospitals, Cairo University, Cairo 11451, Egypt. beero4a@yahoo.com.; Elkholy S; Department of Internal Medicine and Hepatogastroenterology, Kasr Al-Aini Hospitals, Cairo University, Kasr Al-Aini Hospitals, Cairo University, Cairo 11451, Egypt.; Mogawer MS; Department of Internal Medicine and Hepatogastroenterology, Kasr Al-Aini Hospitals, Cairo University, Kasr Al-Aini Hospitals, Cairo University, Cairo 11451, Egypt.; Yosry A; Department of Endemic Diseases, Cairo University, Cairo 11451, Egypt.; Elserafy M; Department of Endemic Diseases, Cairo University, Cairo 11451, Egypt.; Medhat E; Department of Endemic Diseases, Cairo University, Cairo 11451, Egypt.; Khalaf H; Department of Tropical Medicine and Gastroenterology, Minia University, Minia 61511, Egypt.; Fouad M; Department of Tropical Medicine and Gastroenterology, Minia University, Minia 61511, Egypt.; Elbaz T; Department of Endemic Diseases, Cairo University, Cairo 11451, Egypt.; Ramadan A; Department of Endemic Diseases, Cairo University, Cairo 11451, Egypt.; Behiry ME; Department of Internal Medicine, Kasr Al-Aini Hospitals, Cairo University, Cairo 11562, Egypt.; Y William K; Department of Internal Medicine and Hepatogastroenterology, Kasr Al-Aini Hospitals, Cairo University, Kasr Al-Aini Hospitals, Cairo University, Cairo 11451, Egypt.; Habib G; Department of Endemic Diseases, Cairo University, Cairo 11451, Egypt.; Kaddah M; Department of Endemic Diseases, Cairo University, Cairo 11451, Egypt.; Abdel-Hamid H; Department of Tropical Medicine and Gastroenterology, Minia University, Minia 61511, Egypt.; Abou-Elmagd A; Department of Gastroenterology, Armed forces College of Medicine, Cairo 11451, Egypt.; Galal A; Endoscopy and Internal Medicine Consultant at Dr/Ahmed Galal Endoscopy Center, Alexandria 35516, Egypt.; Abbas WA; Department of Internal Medicine, Faculty of Medicine, Assuit University, Assuit 71111, Egypt.; Altonbary AY; Department of Gastroenterology and Hepatology, Mansoura University, Mansoura 35511, Egypt.; El-Ansary M; Department of Gastroenterology and Hepatology, Theodor Bilharz Research Institute, Cairo 11451, Egypt.; Abdou AE; Department of Microbiology and Immunology, Faculty of Medicine for girls Al-Azhar University, Cairo 11451, Egypt.; Haggag H; Department of Internal Medicine and Hepatogastroenterology, Kasr Al-Aini Hospitals, Cairo University, Kasr Al-Aini Hospitals, Cairo University, Cairo 11451, Egypt.; Abdellah TA; Department of Internal Medicine, Faculty of Medicine, Ain shams University, Cairo 11451, Egypt.; Elfeki MA; Department of Internal Medicine, Bani-suef University, Bani-suef, Bani-suef 62511, Egypt.; Faheem HA; Department of Internal Medicine, Faculty of Medicine, Ain shams University, Cairo 11451, Egypt.; Khattab HM; Department of Pathology, Faculty of Medicine, Cairo University, Cairo 11451, Egypt.; El-Ansary M; Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo 11451, Egypt.; Beshir S; Department of Environmental Medicine & Clinical Pathology, National Research Centre, Cairo 11451, Egypt.; El-Nady M; Department of Internal Medicine and Hepatogastroenterology, Kasr Al-Aini Hospitals, Cairo University, Kasr Al-Aini Hospitals, Cairo University, Cairo 11451, Egypt. |
| Source: | World journal of gastrointestinal endoscopy [World J Gastrointest Endosc] 2022 Jun 16; Vol. 14 (6), pp. 402-415. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 101532474 Publication Model: Print Cited Medium: Print ISSN: 1948-5190 (Print) NLM ISO Abbreviation: World J Gastrointest Endosc Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group; Original Publication: Beijing, China : Baishideng |
| Abstract: | 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 lesions.; Aim: 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 lesions.; Methods: 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 PCLs.; Results: 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 lesions.; Conclusion: EUS examination of cyst morphology with cytopathological analysis and cyst fluid analysis could improve the differentiation between malignant and benign pancreatic cysts. Also, CEA, glucose, and SPINK1 could be used as promising markers to predict malignant pancreatic cysts.; (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.) |
| Competing Interests: | Conflict-of-interest statement: No conflict of interest exists. |
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| Contributed Indexing: | Keywords: Amylase; Intraductal papillary mucinous neoplasm; Mucin stain; Mucinous cystic neoplasm; Pancreatic cystic neoplasm |
| Entry Date(s): | Date Created: 20220818 Latest Revision: 20220819 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC9265252 |
| DOI: | 10.4253/wjge.v14.i6.402 |
| PMID: | 35978716 |
| Database: | MEDLINE |
Journal Article