Fluid analysis prior to surgical resection of suspected mucinous pancreatic cysts. A single centre experience
Fluid analysis prior to surgical resection of suspected mucinous pancreatic cysts. A single centre experience
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DOI：
10.3978/j.issn.2078-6891.2011.020
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发表时间：
2011-12-01
影响因子：
2.1
通讯作者：
Dewitt, John
中科院分区：
文献类型：
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作者：
Al-Rashdan, Abdullah;Schmidt, C. Max;Dewitt, John
目的：超声内镜下细针穿刺细胞学检查和液体分析常被用于评估胰腺囊肿。囊液CEA升高通常提示胰腺粘液囊肿，但CEA或淀粉酶值是否能对各种粘液囊肿进行亚分类尚不清楚。本研究的目的是确定是否囊液CEA和淀粉酶获得EUS-FNA可以区分粘液性囊性肿瘤（MCNs）和导管内乳头状粘液性肿瘤（IPMNs.Methods）：使用我们的前瞻性医院EUS和手术数据库，我们确定了所有患者接受EUS的胰腺囊肿手术切除术前，在过去的10年。囊肿在病理学上被细分为MCN或IPMN;所有其他囊肿被认为是非粘液性的。结果：134例胰腺囊肿行手术治疗，其中82例（63%）术前行EUS检查，术后12周行超声内镜检查。在61/82例（74%）患者中进行了EUSFNA，在35/61例（57%）患者中进行了囊液分析，其中分别在35例和33例患者中进行了CEA和淀粉酶分析。组织学检查显示10例为非粘液性囊肿，25例为粘液性囊肿，包括MCNs（n=9）和IPMN（n=16）。所有IPMN和MCN之间的囊液CEA（p=0.19）和淀粉酶（p=0.64）相似。分支导管IPMNs和MCNs之间，囊液CEA（p=0.34）和淀粉酶（p=0.92）也similar.Conclusion：在这个单中心研究中，胰腺囊液淀粉酶和CEA水平似乎是有限的价值，影响粘液性胰腺囊肿的分化。建议进行更大规模的研究，以进一步评估这一作用。
Objective: EUS-FNA cytology and fluid analysis are frequently utilized to evaluate pancreatic cysts. Elevated cyst fluid CEA is usually indicative of a mucinous pancreatic cyst but whether CEA or amylase values can subclassify various mucinous cysts is unknown. The purpose of this study is to determine whether cyst fluid CEA and amylase obtained by EUS-FNA can differentiate between mucinous cystic neoplasms (MCNs) and intraductal papillary mucinous neoplasms (IPMNs).Methods: Using our prospective hospital EUS and surgical databases, we identified all patients who underwent EUS of a pancreatic cyst prior to surgical resection, in the last 10 years. Cysts were pathologically sub-classified as MCNs or IPMNs; all other cysts were considered non-mucinous. Values of cyst fluid CEA and amylase were correlated to corresponding surgical histopathology and compared between the two groups.Results: 134 patients underwent surgery for pancreatic cysts including 82 (63%) that also had preoperative EUS. EUSFNA was performed in 61/82 (74%) and cyst fluid analysis in 35/61 (57%) including CEA and amylase in 35 and 33 patients, respectively. Histopathology in these 35 cysts demonstrated nonmucinous cysts in 10 and mucinous cysts in 25 including: MCNs (n=9) and IPMNs (n=16). Cyst fluid CEA (p=0.19) and amylase (p=0.64) between all IPMNs and MCNs were similar. Between branched duct IPMNs and MCNs alone, cyst fluid CEA (p=0.34) and amylase (p=0.92) were also similar.Conclusion: In this single center study, pancreatic cyst fluid amylase and CEA levels appeared to be of limited value to influence the differential of mucinous pancreatic cysts. Larger studies are recommended to evaluate this role further.