Impact of endoscopic ultrasonography (EUS) and EUS-guided fine needle aspiration (EUSFNA) on the management of pancreatic cystic lesions: Preliminary results

Abstract

s / Pancreatology 13 (2013) e1–e19 e10 Aim: To evaluate the accuracy of CEA, Ca 72.4 and Ca 15.3, obtained by EUS-FNA in CPL in the detection of pre/malignant lesions. Methods: Prospective and consecutive inclusi on of patients submitted to perform an EUS-FNA in the work-up of a CPL. Final diagnosis is based in histology of surgical specimens or in the clinical-radiological, cytological and intracystic markers global evaluation, with a minimum period of follow-up of 6 months. Statistical analysis: t student. S,E,PPV and NPV were calculated after drawing the correspondent ROC curves. Results: 34 patients (mean age 66 years, range 37-86, 13 males) were included. Final diagnosis: 17 IPMN 3 mucinous cystoadenomas, 5 serous cystoadenomas, 4 pseudocysts and 5 adenocarcinomas with cystic degeneration. Mean values obtained for Ca 15.3, Ca 72.4 and CEA in adenocarcinomas (ADC) and mucinous lesions (ML) were 66,4 U/ml, 31,4 U/ml y 3645,5 ng/ml against values for benign lesions (BL): 3,8 U/ml, 5,6 U/ml and 63,6 ng/ml, only with statistical significance for the CEA levels (p 0.011). Cut-off point of CEA of 116.8 ng/ml distinguishes BL from PML with a S,E,PPV and PNV of 75%, 90.9%, 94.7% and 60%. Conclusions: Ca 72.5, Ca 15.3 and CEA levels are higher in PML than BL. CEA levels higher than 116.8 ng/mL differentiates BL from PML with high specificity and PPV.