Expression of mucin-like carcinoma-associated antigen in the cyst fluid differentiates mucinous from nonmucinous pancreatic cysts.
OBJECTIVE
Differential diagnosis of pancreatic cystic lesions may be difficult: the main problem is to distinguish mucinous neoplasms from nonmucinous cysts. We evaluated the usefulness of the mucin-like carcinoma-associated antigen (MCA) in the fluid of pancreatic cysts for detecting mucinous neoplasms. Results were compared with those of CA 15-3, carcinoembryonic antigen (CEA), and CA 72-4 fluid content, and cytology.


METHODS
Twenty-four pancreatic cyst fluids were collected from 10 pseudocysts, eight mucinous cystic tumors, and six serous cystadenomas.


RESULTS
MCA was elevated in seven of eight mucinous tumors (sensitivity 87.5%, specificity 100%). A significant difference was found between MCA levels in mucinous neoplasms versus pseudocysts (p = 0.0003) and serous cystadenomas (p = 0.001). Mean MCA levels were higher (133.7 U/ml) in mucinous cystadenocarcinomas than in cystadenomas (37.5 U/ml). The sensitivity of CA 15-3, CEA, and CA 72-4 in detecting mucinous neoplasms was 50, 87.5, and 87.5%, respectively, with a specificity of 94%, 44%, and 94%, respectively. Cytology showed mucinous epithelial cells in only four of eight mucinous neoplasms, with a specificity of 100%.


CONCLUSIONS
These data suggest that MCA determination in the cyst fluid is a promising new tumor marker for the preoperative diagnosis of mucinous cystic neoplasms of the pancreas.
Sperti
C
C
The Department of Surgery, University of Padua, Padova, Italy.
Pasquali
C
C
Pedrazzoli
S
S
Guolo
P
P
Liessi
G
G
D000951:Antigens, Neoplasm / Q000032:analysis*; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis*; D002272:Carcinoembryonic Antigen / Q000032:analysis; D018291:Cystadenoma, Mucinous / Q000175:diagnosis; D018293:Cystadenoma, Serous / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D018396:Mucin-1 / Q000032:analysis; D009077:Mucins / Q000032:analysis*; D010181:Pancreatic Cyst / Q000175:diagnosis*; D010190:Pancreatic Neoplasms / Q000175:diagnosis; D010192:Pancreatic Pseudocyst / Q000175:diagnosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D000951:Antigens, Neoplasm; D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; C083825:CA-72-4 antigen; D002272:Carcinoembryonic Antigen; D018396:Mucin-1; D009077:Mucins; C057387:mucinous carcinoma-associated antigen