Evidence map›Paper›PMID 40507590›Full record

ReviewJournal of clinical medicine2025

Endoscopic Ultrasound-Guided Pancreatic Cystic Fluid Biochemical and Genetic Analysis for the Differentiation Between Mucinous and Non-Mucinous Pancreatic Cystic Lesions.

Angelo Bruni, Luigi Tuccillo, Giuseppe Dell'Anna, Francesco Vito Mandarino, Andrea Lisotti, Marcello Maida, Claudio Ricci, Lorenzo Fuccio, Leonardo Henry Eusebi, Giovanni Marasco and 1 more

Abstract readReview
In one paragraph

Review in Journal of clinical medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Angelo BruniIRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola, 40138 Bologna, Italy.ORCID 0009-0002-0895-1225
Luigi TuccilloIRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola, 40138 Bologna, Italy.ORCID 0000-0002-0007-8823
Giuseppe Dell'AnnaGastroenterology and Gastrointestinal Endoscopy Unit, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy.ORCID 0000-0002-9395-5468
Francesco Vito MandarinoGastroenterology and Gastrointestinal Endoscopy Unit, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy.ORCID 0000-0002-9931-7221
Andrea LisottiGastroenterology Unit, Hospital of Imola, University of Bologna, 40126 Bologna, Italy.ORCID 0000-0002-7724-7402
Marcello MaidaDepartment of Medicine and Surgery, University of Enna 'Kore', 94100 Enna, Italy.ORCID 0000-0002-4992-9289
Claudio RicciIRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola, 40138 Bologna, Italy.
Lorenzo FuccioIRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola, 40138 Bologna, Italy.
Leonardo Henry EusebiIRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola, 40138 Bologna, Italy.ORCID 0000-0003-3323-7744
Giovanni MarascoIRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola, 40138 Bologna, Italy.ORCID 0000-0001-7167-8773
Giovanni BarbaraIRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola, 40138 Bologna, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pancreatic cystic lesions (PCLs) are increasingly identified via computerized tomography (CT) and magnetic resonance (MR), with a prevalence of 2-45%. Distinguishing mucinous PCLs (M-PCLs), which include intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) that can progress to pancreatic ductal adenocarcinoma, from non-mucinous PCLs (NM-PCLs) is essential. Carcinoembryonic antigen (CEA) remains widely used but often demonstrates limited sensitivity and specificity. In contrast, endoscopic ultrasound-guided measurement of intracystic glucose more accurately differentiates PCL subtypes, as tumor-related metabolic changes lower cyst fluid glucose in mucinous lesions. Numerous prospective and retrospective studies suggest a glucose cut-off between 30 and 50 mg/dL, yielding a sensitivity of 88-95% and specificity of 76-91%, frequently outperforming CEA. Additional benefits include immediate point-of-care assessment via standard glucometers and minimal interference from blood contamination. DNA-based biomarkers, including KRAS and GNAS mutations, enhance specificity (up to 99%) but exhibit moderate sensitivity (61-71%) and necessitate specialized, expensive platforms. Molecular analyses can be crucial in high-risk lesions, yet their uptake is constrained by technical challenges. In practice, combining glucose assessment with targeted molecular assays refines risk stratification and informs the choice between surgical resection or active surveillance. Future investigations should establish standardized glucose thresholds, improve the cost-effectiveness of genetic testing, and integrate advanced biomarkers into routine protocols. Ultimately, these strategies aim to optimize patient management, limit unnecessary interventions for benign lesions, and ensure timely therapy for lesions at risk of malignant transformation.

Indexed as

intracystic glucosemucinous differentiationpancreatic cystic

Identifiers

PMID40507590
PMCPMC12155982

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Registered trials

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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.