ArticleSurgical endoscopy2023
Validation of combined carcinoembryonic antigen and glucose testing in pancreatic cyst fluid to differentiate mucinous from non-mucinous cysts.
Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- EUS-Anchored Multimodal Evaluation of Pancreatic Cystic Lesions: Toward a Conceptual Diagnostic Framework.Journal of clinical medicine · 2026Review
- Evaluating the prognostic efficacy of biomarkers in pancreatic cyst fluid.World journal of gastrointestinal endoscopy · 2025Review
- Single GNAS Droplet-Based Digital Polymerase Chain Reaction Analysis of Pancreatic Cyst Fluid: An Effective Up-Front Strategy for Mucinous Cyst Diagnosis by Endoscopic Ultrasound-Guided Fine-Needle Aspiration.Clinical and translational gastroenterology · 2025Article
- 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
- Cytology-Radiology Correlation Series: Pancreatic cytopathology.Cancer cytopathology · 2025Review
- Intracystic Glucose Measurement for On-Site Differentiation Between Mucinous and Non-Mucinous Pancreatic Cystic Lesions.Cancers · 2024Article
- Article
- Endoscopic ultrasound-guided fine-needle aspiration for pancreatic cystic lesions: a comprehensive review.Journal of medical ultrasonics (2001) · 2024Review
- Neutrophil Gelatinase-Associated Lipocalin for the Differentiation of Mucinous Pancreatic Cystic Lesions.International journal of molecular sciences · 2024Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMore accurate diagnosis of mucinous cysts will reduce the risk of unnecessary pancreatic surgery. Carcinoembryonic antigen (CEA) and glucose in pancreatic cyst fluid (PCF) can differentiate mucinous from non-mucinous pancreatic cystic neoplasms (PCN). The current study assessed the value of combined CEA and glucose testing in PCF.
methodsCross-sectional validation study including prospectively collected PCF from patients undergoing endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) and pancreatic surgery. We performed laboratory measurements for CEA and glucose and measured glucose levels by a hand glucometer. Primary outcome was diagnostic accuracy evaluated by receiver operator curves (ROC), sensitivity, specificity, positive, and negative predictive value (PPV, NPV).
resultsOverall, PCF was collected from 63 patients, including 33 (52%) with mucinous and 30 (48%) with non-mucinous PCN. Histopathology (n = 36; 57%), cytopathology (n = 2; 3%), or clinical and/or radiological diagnosis (n = 25; 40%) was used as reference standard. Combined CEA (cut-off ≥ 192 ng/ml) and laboratory glucose testing (cut-off ≤ 50 mg/dL) reached 92% specificity and 48% sensitivity, whereas either positive CEA (cut-off ≥ 20 ng/ml) or glucose testing (cut-off ≤ 50 mg/dL) showed 97% sensitivity and 50% specificity. Sensitivity and specificity were 80% and 68% for CEA ≥ 20 ng/mL versus 50% and 93% for CEA ≥ 192 ng/mL (the conventional cut-off level). Laboratory and glucometer glucose both reached 100% sensitivity and 60% and 45% specificity, respectively. None of the biomarkers and cut-offs reached a PPV exceeding 90%, whereas both glucose measurements had a NPV of 100% (i.e., high glucose excludes a mucinous cyst).
conclusionCombined CEA and glucose testing in PCF reached high specificity and sensitivity for differentiating mucinous from non-mucinous PCN. Glucose testing, whether alone or combined with the new CEA cut-off (≥ 20 ng/mL), reached > 95% sensitivity for mucinous cysts, whereas only glucose reached a NPV > 95%.
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