Cyst Fluid Glucose is Rapidly Feasible and Accurate in Diagnosing Mucinous Pancreatic Cysts.

Abstract

OBJECTIVES:

Better diagnostic tools are needed to differentiate pancreatic cyst subtypes. A previous metabolomic study showed cyst fluid glucose as a potential marker to differentiate mucinous from non-mucinous pancreatic cysts. This study seeks to validate these earlier findings using a standard laboratory glucose assay, a glucometer, and a glucose reagent strip.

METHODS:

Using an IRB-approved prospectively collected bio-repository, 65 pancreatic cyst fluid samples (42 mucinous and 23 non-mucinous) with histological correlation were analyzed.

RESULTS:

Median laboratory glucose, glucometer glucose, and percent reagent strip positive were lower in mucinous vs. non-mucinous cysts (P<0.0001 for all comparisons). Laboratory glucose<50 mg/dl had a sensitivity of 95% and a specificity of 57% (LR+ 2.19, LR- 0.08). Glucometer glucose<50 mg/dl had a sensitivity of 88% and a specificity of 78% (LR+ 4.05, LR- 0.15). Reagent strip glucose had a sensitivity of 81% and a specificity of 74% (LR+ 3.10, LR- 0.26). CEA had a sensitivity of 77% and a specificity of 83% (LR+ 4.67, LR- 0.27). The combination of having either a glucometer glucose<50 mg/dl or a CEA level>192 had a sensitivity of 100% but a low specificity of 33% (LR+ 1.50, LR- 0.00).

CONCLUSIONS:

Glucose, whether measured by a laboratory assay, a glucometer, or a reagent strip, is significantly lower in mucinous cysts compared with non-mucinous pancreatic cysts.

• Authors: Thomas Zikos, Kimberly Pham, Raffick Bowen, Ann M Chen, Subhas Banerjee, Shai Friedland, Monica M Dua, Jeffrey A Norton, George A Poultsides, Brendan C Visser, Walter G Park
• Journal: The American journal of gastroenterology (Am J Gastroenterol) Vol. 110 Issue 6 Pg. 909-14 (Jun 2015) ISSN: 1572-0241 [Electronic] United States
• PMID: 25986360 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers, Tumor
• Carcinoembryonic Antigen
• Glucose

Topics

• Adult
• Aged
• Aged, 80 and over
• Biomarkers, Tumor (analysis, metabolism)
• Biopsy, Fine-Needle
• Carcinoembryonic Antigen (analysis, metabolism)
• Carcinoma, Pancreatic Ductal (diagnosis, metabolism)
• Cyst Fluid (chemistry)
• Cystadenocarcinoma (diagnosis, metabolism)
• Cystadenocarcinoma, Mucinous (diagnosis, metabolism)
• Female
• Glucose (analysis, metabolism)
• Humans
• Male
• Middle Aged
• Neoplasms, Cystic, Mucinous, and Serous (diagnosis, metabolism)
• Pancreatic Cyst (diagnosis, metabolism)
• Pancreatic Neoplasms (diagnosis, metabolism)
• Pancreatic Pseudocyst (diagnosis, metabolism)
• Prospective Studies
• Sensitivity and Specificity
• Young Adult