Optimal carcinoembryonic antigen (CEA) cutoff values in the diagnosis of neoplastic mucinous pancreatic cysts differ among assays.

Autor:	Kim D; Department of Pathology & Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA kimd8@mskcc.org., Margolskee E; Department of Pathology & Laboratory Medicine, Childrens Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Goyal A; Department of Pathology & Laboratory Medicine, Weill Cornell Medical College, New York, New York, USA., Siddiqui MT; Department of Pathology & Laboratory Medicine, Weill Cornell Medical College, New York, New York, USA., Heymann JJ; Department of Pathology & Laboratory Medicine, Weill Cornell Medical College, New York, New York, USA., Rao R; Department of Pathology & Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA., Hayden J; Department of Chemistry, Norton Healthcare, Louisville, Kentucky, USA.
Jazyk:	angličtina
Zdroj:	Journal of clinical pathology [J Clin Pathol] 2024 Nov 19; Vol. 77 (12), pp. 848-852. Date of Electronic Publication: 2024 Nov 19.
DOI:	10.1136/jcp-2023-209136
Abstrakt:	Aim: Pancreatic cyst fluid carcinoembryonic antigen (CEA) is a pivotal test in the diagnosis and management of neoplastic mucinous cysts (NMC) of the pancreas. Cyst fluid CEA levels of 192 ng/mL have been widely used to identify NMC. However, CEA values are unique to and significantly differ between individual assays with various optimal cutoffs reported in the literature for NMC. Here, we investigate the optimal CEA cut-off value of pancreatic cysts from two different assays to identify differences in thresholds. Methods: Pancreatic cyst fluid CEA levels, CEA assay platform (Beckman Dxl (BD) or Siemens Centaur XP (SC)), and clinical/pathological information were retrospectively collected. Cases were categorised into either NMC or non-NMC. Optimal CEA cut-off values were calculated via a receiver operator characteristic curve. Cut-off values were then identified separately by assay platform. Results: In total, 149 pancreatic cystic lesions with concurrent CEA values (SC: n=47; BD: n=102) were included. Histological correlation was available for 26 (17%) samples. The optimal CEA cut-off value for all samples at the study institution was 45.9 ng/mL (area under the curve (AUC)=86, Sn=85.7%, Sp=73.8%). When analysed separately by CEA assay, the cut-off values were 45.9 ng/mL (AUC=84.27, Sn=89.7%, Sp=71.4%) for BD and 24.4 ng/mL (AUC=77, Sn=81.8%, Sp=75%) for SC (p=0.48). Conclusions: This study showed an optimal pancreas cyst CEA cut-off threshold of 45.9 ng/mL, which is lower than commonly cited literature with different cutoffs on the two separate platforms (BD: 45.9 ng/mL, SC: 24.4 ng/mL). Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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