title: Serum tumor markers and cyst fluid analysis are useful for the diagnosis of pancreatic cystic tumors.
abstract: BACKGROUND
  This study was performed to evaluate the utility of serum and cyst fluid analysis for enzymes (amylase and lipase) and tumor markers (carcinoembryonic antigen, CA 19-9, CA 125, and CA 72-4) in the differential diagnosis of cystic pancreatic lesions.
  
  
  METHODS
  Serum and cyst fluid were obtained from 48 patients with pancreatic cysts (21 pseudocysts, 14 mucinous cystic neoplasms, 6 ductal carcinomas, and 7 serous cystadenomas), observed between 1989 and 1994.
  
  
  RESULTS
  Serum CA 19-9 levels were significantly higher in ductal carcinomas (all > 100 U/mL) and mucinous cystic neoplasms (P < 0.05). CA 72-4 cyst fluid levels were significantly higher in mucinous cystic tumors (P < 0.005), with 95% specificity and 80% sensitivity in detecting mucinous or malignant cysts. A combined assay of serum CA 19-9 and cyst fluid CA 72-4 correctly identified 19 of 20 (pre-) malignant lesions (95%), with only 1 false-positive result (3.6%). Cytology showed a sensitivity of 48% and specificity of 100%.
  
  
  CONCLUSIONS
  Any pancreatic cyst with high serum CA 19-9 values, positive cytology, or high CA 72-4 in the fluid should be considered for resection.
authors.affiliation: Department of Surgery, University of Padua, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Sperti
authors.forename: C
authors.initials: C
authors.lastname: Pasquali
authors.forename: P
authors.initials: P
authors.lastname: Guolo
authors.forename: R
authors.initials: R
authors.lastname: Polverosi
authors.forename: G
authors.initials: G
authors.lastname: Liessi
authors.forename: S
authors.initials: S
authors.lastname: Pedrazzoli
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000378:metabolism; D000681:Amylases / Q000032:analysis / Q000097:blood; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis / Q000097:blood; D014408:Biomarkers, Tumor / Q000032:analysis / Q000097:blood*; D018394:CA-125 Antigen / Q000032:analysis / Q000097:blood; D018395:CA-19-9 Antigen / Q000032:analysis / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000032:analysis / Q000097:blood; D018282:Cystadenocarcinoma, Mucinous / Q000097:blood / Q000378:metabolism; D018291:Cystadenoma, Mucinous / Q000097:blood / Q000378:metabolism; D018293:Cystadenoma, Serous / Q000097:blood / Q000378:metabolism; D003937:Diagnosis, Differential; D005122:Exudates and Transudates / Q000737:chemistry / Q000201:enzymology; D005260:Female; D006801:Humans; D008049:Lipase / Q000032:analysis / Q000097:blood; D008297:Male; D010181:Pancreatic Cyst / Q000097:blood / Q000175:diagnosis / Q000378:metabolism*; D010183:Pancreatic Ducts; D010190:Pancreatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000378:metabolism*; D010192:Pancreatic Pseudocyst / Q000097:blood / Q000378:metabolism; D012680:Sensitivity and Specificity
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; C083825:CA-72-4 antigen; D002272:Carcinoembryonic Antigen; D008049:Lipase; D000681:Amylases