Adam Durczynski and Janusz Strzelczyk
Pancreatic cystic neoplasms account for approximately 10% of all pancreatic neoplasms and frequency of occurrence increases with age. Among cystic neoplasms, there are benign and malignant lesions. Malignant cysts are mainly diagnosed in the group of mucinous neoplastic cysts (containing mucinous fluid). The current guidelines for the management of asymptomatic pancreatic cystic lesions (consensus) is based mainly on the radiological features of PCL and Endoscopic Ultrasonography with Fine Needle Aspiration (EUS-FNA), which are controversial, mainly due to the limited sensitivity. The histopathological examination in each case concerned the entire lesion (pancreatic resections, local excisions) or a full walled sample (after drainage or palliative operations). However, as shown by the results in this study, the increased concentration of the CEA marker in the fluid does not correlate into an increased concentration in the blood. Although no differences were found in the mean blood concentration of the marker CEA and Ca 19-9 in the study groups, elevated values in the blood of these markers occurred in some cases of MCN, IPMN and non-neoplastic cysts. Tumor markers were determined by Electrohemiluminescence (ECL) using CEA specific biotinylated monoclonal antibodies and Ca 19-9 specific monoclonal antibodies. Mucinous neoplastic cysts, non-mucinous neoplastic cysts and non-neoplastic cysts do not differ in mean blood concentration of tumor markers Ca 19-9 and CEA. Since there is no single, widely used, non-invasive examination that differentiates mucinous neoplastic cysts with high sensitivity and specificity, researchers are moving towards the development of diagnostic systems combining multiple features, which significantly improved differentiation. According to experience of authors of this study, blood concentration of Ca 19-9 and CEA tumor markers should be considered as a rather supplement to the clinical data, imaging test, EUS-FNA and examinations of fluid from PCL.
Published Date: 2023-06-19; Received Date: 2023-05-12
