Differential diagnosis of pancreatic cysts: A prospective study on the role of intra-cystic glucose concentration.

Abstract

BACKGROUND:

The accuracy and costs of current diagnostic methods in the differential diagnosis of pancreatic cystic lesions still has ample room for improvement.

AIMS:

The aim of the study was to confirm the diagnostic yield of intracystic glucose in the diagnosis of pancreatic cyst subtypes.

METHODS:

We prospectively recruited all patients who underwent Endoscopic Ultrasound with Fine Needle Aspiration of pancreatic cyst at our Institution.

RESULTS:

Fifty-six patients were included in the study. We found that intracystic glucose concentration < 50 mg/dL was significantly more sensitive than a concentration of Carcinoembryonic Antigen > 192 ng/mL (93.6% vs 54.8%; p = 0.003) for the diagnosis of mucinous cysts. In terms of specificity, the two markers were not different (96% vs 100%; p = 1). Regarding the diagnosis of non-mucinous cysts, intracystic glucose concentration ≥ 50 mg/mL showed higher sensitivity than Carcinoembryonic Antigen level < 5 ng/mL (96% vs 72%) although a statistical significance could not be reached (p = 0.07). The two markers were not statistically different in terms of specificity (93.6% vs 87.1%; p = 0.62).

CONCLUSION:

Given its diagnostic performance and ease of measurement, intracystic glucose may replace Carcinoembryonic Antigen in the differential diagnosis of mucinous versus non-mucinous pancreatic cysts.

• Authors: Davide Giuseppe Ribaldone, Mauro Bruno, Silvia Gaia, Alessandro Cantamessa, Alberto Bragoni, Paola Caropreso, Marco Sacco, Sharmila Fagoonee, Giorgio Maria Saracco, Claudio De Angelis
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 52 Issue 9 Pg. 1026-1032 (09 2020) ISSN: 1878-3562 [Electronic] Netherlands
• PMID: 32675041 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Carcinoembryonic Antigen
• Glucose

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoembryonic Antigen (metabolism)
• Cystadenoma (diagnosis, metabolism)
• Diagnosis, Differential
• Endoscopic Ultrasound-Guided Fine Needle Aspiration
• Female
• Glucose (metabolism)
• Humans
• Male
• Middle Aged
• Pancreatic Cyst (diagnosis, metabolism)
• Pancreatic Intraductal Neoplasms (diagnosis, metabolism)
• Pancreatic Neoplasms (diagnosis, metabolism)
• Prospective Studies
• ROC Curve
• Sensitivity and Specificity