Co-analysis of pancreatic cyst fluid carcinoembryonic antigen and glucose with novel cut-off levels better distinguishes between mucinous and non-mucinous neoplastic pancreatic cystic lesions

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dc.authoridAk, Gunes/0000-0001-6780-1812
dc.authoridBarutcuoglu, Burcu/0000-0001-6570-5229
dc.authorscopusid12771000600
dc.authorscopusid6602755790
dc.authorscopusid57221276715
dc.authorscopusid57320329500
dc.authorscopusid7102287961
dc.authorscopusid6602613003
dc.authorscopusid56211674500
dc.authorwosidAk, Gunes/AAA-6769-2020
dc.contributor.authorBarutcuoglu, Burcu
dc.contributor.authorOruc, Nevin
dc.contributor.authorAk, Gunes
dc.contributor.authorKucukokudan, Serdar
dc.contributor.authorAydin, Ahmet
dc.contributor.authorNart, Deniz
dc.contributor.authorHarman, Mustafa
dc.date.accessioned2023-01-12T20:03:30Z
dc.date.available2023-01-12T20:03:30Z
dc.date.issued2022
dc.departmentN/A/Departmenten_US
dc.description.abstractBackground Pancreatic cyst fluid analysis plays an important role in distinguishing between mucinous and non-mucinous cyst lesions. We aimed to compare the diagnostic performances of cyst fluid carcinoembryonic antigen (CEA), CA 19-9, and glucose in differentiating mucinous from non-mucinous neoplastic pancreatic cystic lesions (PCLs) and determine the best cut-off levels. Methods Patients' data were evaluated retrospectively. 102 patients' PCLs were grouped as non-neoplastic (n = 25), non-mucinous neoplastic (n = 20), mucinous neoplastic (n = 47) and pancreatic adenocarcinomas with cystic degeneration (n = 10); and CEA, CA 19-9, and glucose levels were compared. Receiver-operating characteristic analysis was performed, and the ideal cut-off values were determined. Results Cyst fluid CEA and CA 19-9, levels were significantly higher (P < 0.001, P < 0.001, respectively) and glucose levels were significantly lower (P = 0.001) in mucinous than in non-mucinous neoplastic PCLs. Area under curve with 95% confidence interval of CEA, glucose and CEA and glucose test combination was 0.939 (95% CI = 0.885-0.993, P = 0.001), 0.809 (95% CI = 0.695-0.924, P < 0.001) and 0.937 (95% CI = 0.879-0.995), respectively. CEA cut-offs to rule-in and rule-out mucinous neoplastic were 135.1 ng/mL (sensitivity = 62%, specificity = 94.7%) and 6.12 ng/mL (sensitivity = 94.1%, specificity = 80.4%), respectively. Glucose cut-off of 2.8 mmol/L was chosen both to rule-in and rule-out mucinous neoplastic PCLs (sensitivity = 78%, specificity = 80%). Co-analysis of CEA and glucose to distinguish mucinous from non-mucinous neoplastic PCLs had sensitivity = 87.8%, specificity = 93.3%, and diagnostic accuracy = 89.3%. Conclusions We concluded that co-analysis of cyst fluid CEA (cut-off = 135.1 ng/mL) and glucose (cut-off = 2.8 mmol/L) at novel cut-offs had the best testing performance to rule-in mucinous neoplastic PCLs. To rule-out mucinous PCLs co-analysis of CEA (cut-off = 6.12 ng/mL) and glucose (cut-off = 2.8 mmol/L) added value to prediction.en_US
dc.identifier.doi10.1177/00045632211053998
dc.identifier.endpage133en_US
dc.identifier.issn0004-5632
dc.identifier.issn1758-1001
dc.identifier.issue2en_US
dc.identifier.pmid34719238en_US
dc.identifier.scopus2-s2.0-85118324548en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage125en_US
dc.identifier.urihttps://doi.org/10.1177/00045632211053998
dc.identifier.urihttps://hdl.handle.net/11454/77701
dc.identifier.volume59en_US
dc.identifier.wosWOS:000713701200001en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSage Publications Incen_US
dc.relation.ispartofAnnals of Clinical Biochemistryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectpancreatic cystic lesionen_US
dc.subjectcarcinoembryonic antigenen_US
dc.subjectglucoseen_US
dc.subjectFine-Needle-Aspirationen_US
dc.subjectDifferential-Diagnosisen_US
dc.subjectEndoscopic Ultrasounden_US
dc.subjectManagementen_US
dc.subjectPerformanceen_US
dc.subjectBiomarkersen_US
dc.subjectAccuracyen_US
dc.subjectCytologyen_US
dc.subjectAmylaseen_US
dc.subjectCeaen_US
dc.titleCo-analysis of pancreatic cyst fluid carcinoembryonic antigen and glucose with novel cut-off levels better distinguishes between mucinous and non-mucinous neoplastic pancreatic cystic lesionsen_US
dc.typeArticleen_US

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