Cyst Fluid Biomarkers - Diagnosis and Prediction of Malignancy for Cystic Lesions of the Pancreas

Raman, Aadhithya; Lennon, Anne Marie

doi:10.1159/000490137

Cited by 19 publications

(15 citation statements)

References 38 publications

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“…IPMNs and MCNs are pancreatic cysts, which have a higher malignant rate than other types of PCNs. Currently available tools are imperfect at differentiating IPMNs and MCNs from other benign types of pancreatic cysts …”

Section: Discussionmentioning

confidence: 99%

“…However, cystic fluid amylase level of <250 IU/L may exclude pancreatic pseudocysts, but a higher level of amylase does not differentiate mucinous from non‐mucinous cysts. Currently, available cystic fluid biomarkers still cannot identify high‐grade dysplasia or invasive carcinoma preoperatively …”

Section: Discussionmentioning

confidence: 99%

“…Some molecular markers show promise for diagnosis of possible predictors of high‐grade dysplasia or invasive carcinoma; however, larger studies are required before these molecular markers can be recommended in clinical practice. More cost‐effective and precise biomarkers may be available for differentiating PCNs in the future . Furthermore, the pathology is still the final and conclusive judgment for differentiating pancreatic mucinous cyst.…”

Section: Discussionmentioning

confidence: 99%

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Challenge in differentiation of pancreatic cystic neoplasms between intraductal papillary mucinous neoplasm and mucinous cystic neoplasm: A case report

Pan

Chen

et al. 2020

Adv in Digestive Medicine

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Incidental pancreatic cystic neoplasms (PCNs) are frequently detected as a result of advances in imaging technologies nowadays. Cystic lesions with higher malignant potential include mucinous neoplasms, such as intraductal papillary mucinous neoplasm (IPMN) and mucinous cystic neoplasm (MCN). There are crucial differences between MCN and IPMN in their biological behavior and clinical prognosis. However, currently available tools are imperfect to differentiate between IPMN and MCN. We reported a case of a 46‐year‐old woman with incidental pancreatic tail cyst of 8 cm size. Computed tomography scan and endoscopic ultrasound with fine‐needle aspiration showed a tumor located at the pancreatic tail. The macrocystic lesion had septa and peripheral calcification, and cystic fluid analysis revealed high level of carcinoembryonic antigen (CEA) with low level of amylase. These clinical features are suggestive of MCN in previous experience. Patient underwent laparoscopic distal partial pancreatectomy and splenectomy. The final pathological result was IPMN. Following the application of updated 2017 consensus guideline and 2018 American College of Gastroenterology (ACG) guideline will provide more precise preoperative evaluation and postoperative surveillance. We try to explain the discrepancy between the diagnostic modalities, and more cost‐effective, validated biomarkers are required for differentiating PCNs in the future.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Challenge in differentiation of pancreatic cystic neoplasms between intraductal papillary mucinous neoplasm and mucinous cystic neoplasm: A case report

Pan

Chen

et al. 2020

Adv in Digestive Medicine

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“…The review articles in this issue on biomarkers [3], radiological workup [4], and endoscopy [5] describe the evidence available regarding diagnostics today, while the articles by Beyer et al [6], Andrianello et al [7], as well as D'Haese and Werner [8] summarize the latest advances in treatment, including the indications for surgery and the different options of resection. Despite the increasing data on the management of cystic lesions, the controversy regarding the best treatment remains.…”

Section: Disclosure Statementmentioning

confidence: 99%

“…In the 'Interdisciplinary Discussion' chaired by Werner [9], all international experts agree that a blood-based test and biomarkers are needed for better and cost-effective surveillance in the future. The article by Raman and Lennon [3] in this issue also highlights the evidence available today.Last but not least, as guest editors of this issue on cystic lesions of the pancreas, we would like to express our gratitude and appreciation to all the authors for their outstanding efforts and great contributions. …”

mentioning

confidence: 95%

Cystic Lesions of the Pancreas

Mayerle

Werner

2018

Visc Med

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tion for pancreatic cancer since extended resections are rarely needed. Moreover, many reports have been published which demonstrate that the development of pancreatic cancer cannot be avoided in all patients despite close follow-up. Overall, this might be a rare event, and some publications claim that the risk of malignancy in pancreatic cystic lesions is lower than previously reported. Thus, a general practitioner or even a specialized pancreatologist might not observe the development of cancer in many of his patients. In contrast, large surgical centers report more and more often on the development of pancreatic cancer and even unresectable cancers in a significant number of their patients. Therefore, apart from the evidence available, personal experience with the disease and the different treatment options will continue to influence our decision making in daily practice.In addition, the best way of follow-up of patients with pancreatic cysts is also very controversial and depends on the type of cyst, the potential of its malignant transformation (secondary to risk factors), as well as the age and risk profile of the patient. The follow-up of the increasing amount of patients with pancreatic cysts is time-consuming, expensive, and not well defined. In the 'Interdisciplinary Discussion' chaired by Werner [9], all international experts agree that a blood-based test and biomarkers are needed for better and cost-effective surveillance in the future. The article by Raman and Lennon [3] in this issue also highlights the evidence available today.Last but not least, as guest editors of this issue on cystic lesions of the pancreas, we would like to express our gratitude and appreciation to all the authors for their outstanding efforts and great contributions. Disclosure StatementA conflict of interest does not exist.The awareness of pancreatic cystic lesions has dramatically increased over the past decades. Due to increasing precision and the more frequent use of modern imaging modalities, cystic lesions of the pancreas are diagnosed more often. They differ in their clinical presentation, morphology, and, most importantly, their risk of malignant transformation.The diagnostic tool box to define the type of cyst and its potential risk of malignancy has increased over time; however, diagnostic accuracy is still not higher than 80%.Furthermore, despite the definition of risk factors for malignancy, the differentiation between benign and malignant cysts is still difficult and in many cases impossible. Several guidelines have discussed the management of cystic lesions of the pancreas, although most of the guideline papers are consensus statements rather than evidence-based publications. Moreover, there is still quite a controversy about the best treatment and follow-up regimen. The article by Scholten et al. [1] in this issue of Visceral Medicine summarizes the main statements of the first evidencebased guideline on pancreatic cystic neoplasms [2], which was recently published.The review articles in this issue on biomarker...

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EUS‐guided FNAC in intra‐abdominal lesions: Technique of tissue acquisition, ancillary testing, pearls and perils, and prospects

Kundu

Rana

Suneel

et al. 2023

Diagnostic Cytopathology

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Endoscopic ultrasound enables visualization of lesions within and in the vicinity of the gastrointestinal tract. Endoscopic ultrasound guided fine needle aspiration cytology (EUS‐FNAC) helps in targeting various luminal and extraluminal lesions both diagnostically and therapeutically. Various intra‐abdominal organs amenable to EUS‐FNA include the gastrointestinal tract (GIT), pancreas, kidney, adrenal gland, liver, bile duct, gallbladder, spleen, and lymph nodes. EUS‐FNAC is mostly done for pancreatic and intra‐abdominal lymph nodal lesions. In the present review, we have discussed various aspects of EUS‐FNAC.

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Cyst Fluid Biomarkers - Diagnosis and Prediction of Malignancy for Cystic Lesions of the Pancreas

Cited by 19 publications

References 38 publications

Challenge in differentiation of pancreatic cystic neoplasms between intraductal papillary mucinous neoplasm and mucinous cystic neoplasm: A case report

Challenge in differentiation of pancreatic cystic neoplasms between intraductal papillary mucinous neoplasm and mucinous cystic neoplasm: A case report

Cystic Lesions of the Pancreas

EUS‐guided FNAC in intra‐abdominal lesions: Technique of tissue acquisition, ancillary testing, pearls and perils, and prospects

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