title: Cyst fluid carcinoembryonic antigen concentration and cytology by endosonography-guided fine needle aspiration in predicting malignant pancreatic mucinous cystic neoplasms.
abstract: OBJECTIVE
  To assess the value of carcinoembryonic antigen (CEA) level and cytology examination obtained by endosonography-guided fine needle aspiration (EUS-FNA) in predicting the malignancy of pancreatic mucinous cystic neoplasm (MCN).
  
  
  METHODS
  The data of patients with pancreatic MCN who underwent EUS-FNA in Changhai Hospital, Second Military Medical University (Shanghai, China) from November 2005 to April 2010 were collected and analyzed. The area under receiver operating characteristic (ROC) curve of cyst fluid CEA, sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of the cytology as well as cyst fluid CEA were determined.
  
  
  RESULTS
  Of the 20 MCNs confirmed by surgical pathology, 10 were malignant and the remainder were premalignant. Cytology had some value in differentiating malignant from premalignant MCN with a sensitivity of 60.0%, specificity of 100.0%, PPV of 100.0% and NPV of 71.4%. CEA of > 692.8 ng/mL was able to predict malignancy (P = 0.007) with sensitivity of 80.0%, specificity of 90.0%, PPV of 88.9% and NPV of 81.8%, and its area under ROC curve was 0.855.
  
  
  CONCLUSIONS
  Cyst fluid CEA level and cytology obtained by EUS-FNA are useful for predicting the malignancy of pancreatic MCN.
authors.affiliation: Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Xian Bao
authors.initials: XB
authors.lastname: Zhan
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.forename: Feng
authors.initials: F
authors.lastname: Liu
authors.forename: Xiao Fei
authors.initials: XF
authors.lastname: Ye
authors.forename: Zhen Dong
authors.initials: ZD
authors.lastname: Jin
authors.forename: Zhao Shen
authors.initials: ZS
authors.lastname: Li
mesh_terms: D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods; D002272:Carcinoembryonic Antigen / Q000032:analysis*; D020420:Cyst Fluid / Q000276:immunology*; D018282:Cystadenocarcinoma, Mucinous / Q000175:diagnosis*; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D011230:Precancerous Conditions / Q000175:diagnosis; D011237:Predictive Value of Tests; D018084:Ultrasonography, Interventional / Q000379:methods
chemical_list: D002272:Carcinoembryonic Antigen