SERUM TUMOR-MARKERS AND CYST FLUID ANALYSIS ARE USEFUL FOR THE DIAGNOSIS OF PANCREATIC CYSTIC TUMORS

BACKGROUND, This study was performed to evaluate the utility of serum and cyst fluid analysis for enzymes (amylase and lipase) and tumor mar kers (carcinoembryonic antigen, CA 19-9, CA 125, and CA 72-4) in the d ifferential diagnosis of cystic pancreatic lesions. METHODS. Serum and cyst fluid were obtained from 48 patients with pancreatic cysts (21 p seudocysts, 14 mucinous cystic neoplasms, 6 ductal carcinomas, and 7 s erous cystadenomas), observed between 1989 and 1994. RESULTS, Serum CA 19-9 levels were significantly higher in ductal carcinomas (all >100 U/mL) and mucinous cystic neoplasms (P < 0.05). CA 72-4 cyst fluid lev els were significantly higher in mucinous cystic tumors (P < 0.005), w ith 95% specificity and 80% sensitivity in detecting mucinous or malig nant cysts. A combined assay of serum CA 19-9 and cyst fluid CA 72-4 c orrectly identified 19 of 20 (pre-) malignant lesions (95%), with only 1 false-positive result (3.6%). Cytology showed a sensitivity of 48% and specificity of 100%. CONCLUSIONS, Any pancreatic cyst with high se rum CA 19-9 values, positive cytology, or high CA 72-4 in the fluid sh ould be considered for resection. (C) 1996 American Cancer Society.