ArticleEndoscopy international open2016
The value of KRAS mutation testing with CEA for the diagnosis of pancreatic mucinous cysts.
Article in Endoscopy international open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 5 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Utility of Cyst Fluid Carcinoembryonic Antigen in Differentiating Mucinous and Non-mucinous Pancreatic Cysts: An Updated Meta-Analysis.Digestive diseases and sciences · 2022Pooled it
- Diagnostic Performance of Pancreatic Cytology with the Papanicolaou Society of Cytopathology System: A Systematic Review, before Shifting into the Upcoming WHO International System.International journal of molecular sciences · 2022Pooled it
- Genetic testingWorld journal of gastroenterology · 2019Pooled it
- Guideline
- Imaging modalities for characterising focal pancreatic lesions.The Cochrane database of systematic reviews · 2017Pooled it
- Mass Spectrometry-Based Comprehensive Analysis of Pancreatic Cyst Fluids.BioMed research international · 2018Trial
- Endoscopic Ultrasound-Guided Pancreatic Cystic Fluid Biochemical and Genetic Analysis for the Differentiation Between Mucinous and Non-Mucinous Pancreatic Cystic Lesions.Journal of clinical medicine · 2025Review
- Serial EUS-Guided FNA for the Surveillance of Pancreatic Cysts: A Study of Long-Term Performance of Tumor Markers.Digestive diseases and sciences · 2022Article
- Non-inflammatory pancreatic cysts: from diagnosis to treatment (97 cases series).Revista do Colegio Brasileiro de Cirurgioes · 2021Article
- Molecular Diagnostics and Testing for Pancreatic Cysts.Current treatment options in gastroenterology · 2020Review
- Endoscopic ultrasound-through-the-needle biopsy in pancreatic cystic lesions: A large single center experience.World journal of gastrointestinal endoscopy · 2019Article
- Position statement on EUS-guided ablation of pancreatic cystic neoplasms from an international expert panel.Endoscopy international open · 2019Review
- Pancreatic Intraductal Papillary Mucinous Neoplasm With Elevated Pre-Operative Cystic Carcinoembryonic Antigen Level: A Histopathologic Correlation.Gastroenterology research · 2019Article
- [Cystic lesions of the pancreas : Differential diagnostics and treatment].Der Internist · 2019Review
- Needle-Based Confocal Laser Endomicroscopy for Evaluation of Cystic Neoplasms of the Pancreas.Digestive diseases and sciences · 2017Article
- Do molecular tests really differentiate malignant IPMNS from benign?Endoscopy international open · 2016Article
- Application of EUS-based techniques in the evaluation of pancreatic cystic neoplasms.Endoscopic ultrasoundReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsPancreatic cyst fluid (PCF) CEA has been shown to be the most accurate preoperative test for detection of cystic mucinous neoplasms (CMNs). This study aimed to assess the added value of PCF KRAS mutational analysis to CEA for diagnosis of CMNs. PATIENTS AND
methodsThis is a retrospective study of prospectively collected endoscopic ultrasonography (EUS) fine-needle aspiration (FNA) data. KRAS mutation was determined by direct sequencing or equivalent methods. Cysts were classified histologically (surgical cohort) or by clinical (EUS or FNA) findings (clinical cohort). Performance characteristics of KRAS, CEA and their combination for detection of a cystic mucinous neoplasm (CMN) and malignancy were calculated.
resultsThe study cohort consisted of 943 patients: 147 in the surgical cohort and 796 in the clinical cohort. Overall, KRAS and CEA each had high specificity (100 % and 93.2 %), but low sensitivity (48.3 % and 56.3 %) for the diagnosis of a CMN. The positivity of KRAS or CEA increased the diagnostic accuracy (80.8 %) and AUC (0.84) significantly compared to KRAS (65.3 % and 0.74) or CEA (65.8 % and 0.74) alone, but only in the clinical cohort (P < 0.0001 for both). KRAS mutation was significantly more frequent in malignant CMNs compared to histologically confirmed non-malignant CMNs (73 % vs. 37 %, P = 0.001). The negative predictive value of KRAS mutation was 77.6 % in differentiating non-malignant cysts.
conclusionsThe detection of a KRAS mutation in PCF is a highly specific test for mucinous cysts. It outperforms CEA for sensitivity in mucinous cyst diagnosis, but the data does not support its routine use.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.