Pancreatic cyst fluid examiantion
CEA Levels: CEA >192 is 60% sensitive and 90% specific for mucinous cysts (ipmn/mcn) This was based on a study of 70 lesions in 2004 and has stuck till date CEA < 5 has excellent negative predictive value for mucinous cysts CEA > 5, therefore can still be a mucinous neoplasm and needs to be taken in context. Other markers such as Ca 72-4, CA 19-9, CA 15-3, CA 125 have lower accuracy than CEA Amylase levels: · Amylase < 250 IU/L is highly unlikely to be connected to PD (eg SCA) · MCN usually have very low / low amylase (one study suggested it has similar amylase to ipmn) Glucose: · Glucose is very low in mucinous tumors & pseudocysts (those with communication to PD)– usually less than 2.8 mmol/l Glucose < 2.8 mmol/l has Sens/Spec of 90/90 ( more accurate) compared to CEA >192 (sens/spec 60...