Oruç Nevin, Aydın Ahmet, Barutcuoğlu Burcu, Aktan Çağdaş, Nart Deniz, Veral Ali
Department of Gastroenterology, Ege University Faculty of Medicine, İzmir, Turkey.
Turk J Gastroenterol. 2015 Nov;26(6):522-7. doi: 10.5152/tjg.2015.0329. Epub 2015 Oct 26.
BACKGROUND/AIMS: 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.
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.
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.
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.
背景/目的：胰腺囊性病变的鉴别诊断范围广泛。持续需要鉴定用于胰腺囊肿鉴别诊断的特异性和敏感性囊液标志物。我们旨在评估囊液嗜铬粒蛋白A（CgA）在胰腺囊肿鉴别诊断中的诊断价值。
纳入接受内镜超声（EUS）引导下胰腺囊肿抽吸术的患者。进行细胞病理学分析和生化分析，包括囊液癌胚抗原（CEA）、淀粉酶、Ca 19-9和CgA。
53例患者纳入研究。患者的最终诊断为14例胰腺假性囊肿、10例导管内乳头状黏液性肿瘤（IPMN）、8例黏液性囊性肿瘤（MCN）、8例浆液性囊腺瘤（SCA）、2例囊性胰腺神经内分泌肿瘤（PNET）和11例其他情况。假性囊肿中CgA平均水平为50.51±130.04 ng/mL，MCN中为12.38±8.59 ng/mL，囊性PNET中为13.76±10.90 ng/mL。仅1例患者囊液CgA非常高（515.49 ng/mL），诊断为慢性胰腺炎患者发生的假性囊肿。2例囊性PNET患者囊液CgA水平正常。
囊液CgA不是囊性PNET鉴别诊断的有用标志物。它在其他胰腺囊肿的鉴别诊断中也无价值。
