Cystic fluid chromogranin A levels in different pancreatic cystic lesions.
OBJECTIVE
Pancreatic cystic lesions have a broad spectrum of differential diagnosis. There is an ongoing demand to identify specific and sensitive cystic fluid markers for the differential diagnosis of pancreatic cysts. We aimed to evaluate the diagnostic value of cystic fluid chromogranin A (CgA) in the differential diagnosis of pancreatic cysts.


METHODS
Patients who underwent endoscopic ultrasound (EUS)-guided aspiration for pancreatic cysts were included in the study. Cytopathological analysis and biochemical analysis, including cystic fluid carcinoembryonic antigen (CEA), amylase, Ca 19-9, and CgA, were performed.


RESULTS
Fifty-three patients were included in the study. The final diagnosis of patients was 14 pancreatic pseudocysts, 10 intraductal papillary mucinous neoplasms (IPMNs), 8 mucinous cystic neoplasms (MCN), 8 serous cystadenomas (SCAs), 2 cystic pancreatic neuroendocrine tumors (PNETs), and 11 others. The mean CgA levels were 50.51±130.04 ng/mL in pseudocysts, 12.38±8.59 in MCN, and 13.76±10.90 in cystic PNET. There was only one patient with a very high cystic fluid CgA (515.49 ng/mL) and was diagnosed as pseudocyst developed in chronic pancreatitis patient. Two patients with cystic PNET had normal levels of cystic fluid CgA.


CONCLUSIONS
Cystic fluid CgA is not a useful marker for the differential diagnosis of cystic PNETs. It also has no value in the differential diagnosis of other pancreatic cysts.
Department of Gastroenterology, Ege University Faculty of Medicine, İzmir, Turkey. nevintr@yahoo.com.
Nevin
N
Oruç
Ahmet
A
Aydın
Burcu
B
Barutcuoğlu
Çağdaş
Ç
Aktan
Deniz
D
Nart
Ali
A
Veral
D000328:Adult; D000368:Aged; D000681:Amylases / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D018395:CA-19-9 Antigen / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D053379:Chromogranin A / Q000032:analysis*; D020420:Cyst Fluid / Q000737:chemistry*; D003937:Diagnosis, Differential; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000737:chemistry / Q000473:pathology; D010181:Pancreatic Cyst / Q000737:chemistry / Q000175:diagnosis* / Q000601:surgery; D010192:Pancreatic Pseudocyst / Q000737:chemistry / Q000175:diagnosis*; D011237:Predictive Value of Tests; D055815:Young Adult
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D053379:Chromogranin A; D000681:Amylases