title: Diagnostic accuracy of cyst fluid amphiregulin in pancreatic cysts.
abstract: BACKGROUND
  Accurate tests to diagnose adenocarcinoma and high-grade dysplasia among mucinous pancreatic cysts are clinically needed. This study evaluated the diagnostic utility of amphiregulin (AREG) as a pancreatic cyst fluid biomarker to differentiate non-mucinous, benign mucinous, and malignant mucinous cysts.
  
  
  METHODS
  A single-center retrospective study to evaluate AREG levels in pancreatic cyst fluid by ELISA from 33 patients with a histological gold standard was performed.
  
  
  RESULTS
  Among the cyst fluid samples, the median (IQR) AREG levels for non-mucinous (n = 6), benign mucinous (n = 15), and cancerous cysts (n = 15) were 85 pg/ml (47-168), 63 pg/ml (30-847), and 986 pg/ml (417-3160), respectively. A significant difference between benign mucinous and malignant mucinous cysts was observed (p = 0.025). AREG levels greater than 300 pg/ml possessed a diagnostic accuracy for cancer or high-grade dysplasia of 78% (sensitivity 83%, specificity 73%).
  
  
  CONCLUSIONS
  Cyst fluid AREG levels are significantly higher in cancerous and high-grade dysplastic cysts compared to benign mucinous cysts. Thus AREG exhibits potential clinical utility in the evaluation of pancreatic cysts.
authors.affiliation: Department of Medicine, Stanford University, Stanford, CA 94305, USA.
authors.forename: May T
authors.initials: MT
authors.lastname: Tun
authors.forename: Reetesh K
authors.initials: RK
authors.lastname: Pai
authors.forename: Shirley
authors.initials: S
authors.lastname: Kwok
authors.forename: Aiwen
authors.initials: A
authors.lastname: Dong
authors.forename: Aparna
authors.initials: A
authors.lastname: Gupta
authors.forename: Brendan C
authors.initials: BC
authors.lastname: Visser
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Norton
authors.forename: George A
authors.initials: GA
authors.lastname: Poultsides
authors.forename: Subhas
authors.initials: S
authors.lastname: Banerjee
authors.forename: Jacques
authors.initials: J
authors.lastname: Van Dam
authors.forename: Ann M
authors.initials: AM
authors.lastname: Chen
authors.forename: Shai
authors.initials: S
authors.lastname: Friedland
authors.forename: Brennan A
authors.initials: BA
authors.lastname: Scott
authors.forename: Rahul
authors.initials: R
authors.lastname: Verma
authors.forename: Anson W
authors.initials: AW
authors.lastname: Lowe
authors.forename: Walter G
authors.initials: WG
authors.lastname: Park
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000378:metabolism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D066258:Amphiregulin; D015415:Biomarkers / Q000378:metabolism; D020420:Cyst Fluid / Q000378:metabolism*; D003937:Diagnosis, Differential; D066255:EGF Family of Proteins; D005260:Female; D006023:Glycoproteins / Q000378:metabolism*; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010181:Pancreatic Cyst / Q000175:diagnosis* / Q000378:metabolism; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: C587848:AREG protein, human; D066258:Amphiregulin; D015415:Biomarkers; D066255:EGF Family of Proteins; D006023:Glycoproteins; D036341:Intercellular Signaling Peptides and Proteins