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Cyst Fluid Carcinoembryonic Antigen Level Difference between Mucinous Cystic Neoplasms and Intraductal Papillary Mucinous Neoplasms
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Ibrahim Hakkı Köker, Nurcan Ünver, Fatma Ümit Malya, Ömer Uysal, Elmas Biberci Keskin, Hakan Şentürk
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Clin Endosc 2021;54(1):113-121. Published online December 11, 2020
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DOI: https://doi.org/10.5946/ce.2020.083
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 Abstract
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- Background
/Aims: The role of cyst fluid carcinoembryonic antigen (CEA) level in differentiating mucinous pancreatic cystic lesions (PCLs) is controversial. We investigated the role of cyst fluid CEA in differentiating low-risk (LR)-intraductal papillary mucinous neoplasms (IPMNs) from high-risk (HR)-IPMNs and LR-mucinous cystic neoplasms (MCNs).
Methods
This was a retrospective study of 466 patients with PCLs who underwent endoscopic ultrasound-guided fine-needleaspiration over a 7-year period. On histology, low-grade dysplasia and intermediate-grade dysplasia were considered LR, whereas high-grade dysplasia and invasive carcinoma were considered HR.
Results
Data on cyst fluid CEA levels were available for 50/102 mucinous PCLs with definitive diagnoses. The median CEA (range) levels were significantly higher in HR cysts than in LR cysts (2,624 [0.5–266,510] ng/mL vs. 100 [16.8–53,445]ng/mL, p=0.0012). The area under the receiver operating characteristic curve (AUROC) was 0.930 (95% confidence interval [CI], 0.5–0.8; p<0.001) for differentiating LR-IPMNs from LR-MCNs. The AUROC was 0.921 (95% CI, 0.823–1.000; p<0.001) for differentiating LR-IPMNs from HR-IPMNs. Both had a CEA cutoff level of >100ng/mL, with a negative predictive value (NPV) of 100%.
Conclusions
Cyst fluid CEA levels significantly vary between LR-IPMNs, LR-MCNs, and HR-IPMNs. A CEA cutoff level of >100ng/mL had a 100% NPV in differentiating LR-IPMNs from LR-MCNs and HR-IPMNs.
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Citations
Citations to this article as recorded by  - An Overview for Clinicians on Intraductal Papillary Mucinous Neoplasms (IPMNs) of the Pancreas
Dimitrios Moris, Ioannis Liapis, Piyush Gupta, Ioannis A. Ziogas, Georgia-Sofia Karachaliou, Nikolaos Dimitrokallis, Brian Nguyen, Pejman Radkani
Cancers.2024; 16(22): 3825. CrossRef - Spectrum of MRI Features of Mucin-producing Neoplasms in the Abdomen and Pelvis
Pei-Kang Wei, Mamta Gupta, Leo L. Tsai, Karen S. Lee, Adrian M. Jaramillo, Martin P. Smith, Jordan D. LeGout, Anuradha S. Shenoy-Bhangle
RadioGraphics.2022; 42(2): 469. CrossRef - Is Carcinoembryonic Antigen the Holy Grail for Pancreatic Cyst Risk Stratification?
Ahmad Najdat Bazarbashi, Linda S. Lee
Clinical Endoscopy.2021; 54(1): 7. CrossRef - Deep Learning-Based Differentiation between Mucinous Cystic Neoplasm and Serous Cystic Neoplasm in the Pancreas Using Endoscopic Ultrasonography
Leang Sim Nguon, Kangwon Seo, Jung-Hyun Lim, Tae-Jun Song, Sung-Hyun Cho, Jin-Seok Park, Suhyun Park
Diagnostics.2021; 11(6): 1052. CrossRef
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