Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
J Dig Dis. 2013 Apr;14(4):191-5. doi: 10.1111/1751-2980.12027.
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).
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.
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.
Cyst fluid CEA level and cytology obtained by EUS-FNA are useful for predicting the malignancy of pancreatic MCN.
评估超声内镜引导下细针抽吸（EUS-FNA）获得的癌胚抗原（CEA）水平和细胞学检查在预测胰腺黏液性囊性肿瘤（MCN）恶性程度中的价值。
收集并分析了 2005 年 11 月至 2010 年 4 月在第二军医大学长海医院接受 EUS-FNA 治疗的胰腺 MCN 患者的数据。确定囊液 CEA、细胞学的 ROC 曲线下面积（AUC）、敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
20 例经手术病理证实的 MCN 中，10 例为恶性，其余为癌前病变。细胞学对鉴别恶性和癌前病变的 MCN 具有一定的价值，敏感性为 60.0%，特异性为 100.0%，PPV 为 100.0%，NPV 为 71.4%。CEA ＞692.8ng/ml 可预测恶性肿瘤（P=0.007），敏感性为 80.0%，特异性为 90.0%，PPV 为 88.9%，NPV 为 81.8%，ROC 曲线下面积为 0.855。
EUS-FNA 获得的囊液 CEA 水平和细胞学检查有助于预测胰腺 MCN 的恶性程度。
