EUS-guided fine needle aspiration-based clues to mistaken or uncertain identity: serous pancreatic cysts.

Autor:	Yip-Schneider MT; Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA; Walther Oncology Center, Indianapolis, IN, USA; Indiana University Simon Cancer Center, Indianapolis, IN, USA; Indiana University Health Pancreatic Cyst and Cancer Early Detection Center, Indianapolis, IN, USA. Electronic address: myipschn@iupui.edu., Muraru R; Center for Outcomes Research in Surgery, Indiana University School of Medicine, Indianapolis, IN, USA., Kim RC; Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA., Wu HH; Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA., Sherman S; Department of Medicine, Division of Gastroenterology, Indiana University School of Medicine, Indianapolis, IN, USA., Gutta A; Department of Medicine, Division of Gastroenterology, Indiana University School of Medicine, Indianapolis, IN, USA., Al-Haddad MA; Department of Medicine, Division of Gastroenterology, Indiana University School of Medicine, Indianapolis, IN, USA., Dewitt JM; Department of Medicine, Division of Gastroenterology, Indiana University School of Medicine, Indianapolis, IN, USA., Schmidt CM; Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Biochemistry/Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA; Walther Oncology Center, Indianapolis, IN, USA; Indiana University Simon Cancer Center, Indianapolis, IN, USA; Indiana University Health Pancreatic Cyst and Cancer Early Detection Center, Indianapolis, IN, USA. Electronic address: maxschmi@iupui.edu.
Jazyk:	angličtina
Zdroj:	HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2023 Dec; Vol. 25 (12), pp. 1587-1594. Date of Electronic Publication: 2023 Sep 09.
DOI:	10.1016/j.hpb.2023.09.009
Abstrakt:	Background/objectives: Pancreatic serous cystic neoplasms (SCN) present a diagnostic challenge given their increasing frequency of detection and benign nature yet relatively high rate of misdiagnosis. Here, imaging and analyses associated with EUS-guided fine-needle aspiration (EUS-FNA) are evaluated for their ability to provide a correct preoperative diagnosis of SCN. Methods: A surgical cohort with confirmed pathological diagnosis of SCN (n = 62) and a surveillance cohort with likely SCN (n = 31) were assessed for imaging (CT/MRI/EUS) and EUS-FNA-based analyses (cytology/DNA analysis for Von Hippel-Lindau [VHL] gene alterations/biomarkers). Results: In the surgical cohort, CT/MRI and EUS respectively predicted SCN in 4 of 58(7%) and 19 of 62(31%). Cyst fluid cytology and VHL alterations predicted SCN in 1 of 51(2%) and 5 of 21(24%), respectively. High specificity cyst fluid biomarkers (vascular endothelial growth factor [VEGF]/glucose/carcinoembryonic antigen [CEA]/amylase) correctly identified SCN in 25 of 27(93%). In the surveillance cohort, cyst fluid biomarkers predicted SCN in 12 of 12(100%) while VHL alterations identified SCN 3 of 10(30%). Conclusion: High specificity cyst fluid biomarkers provided the most sensitive means of diagnosing SCN preoperatively. To obtain a preoperative diagnosis of SCN at the highest level of certainty, a multidisciplinary approach should be taken to inform appropriate SCN management. (Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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