New combination of tests identify patients with benign pancreatic cysts

Editor's Note

The combination of two molecular biology tests is the first to distinguish, with near certainty, pancreatic lesions that mimic early signs of cancer but are completely benign, this study finds.

The vascular endothelial growth factor-A test alone singled out benign serious cystic neoplasms with a sensitivity of 100% and specificity of 83.7%. The carcinoembryonic antigen test had a 95.5% sensitivity and 81.5% specificity. Together, the tests approached the gold standard for pathologic diagnosis, importantly avoiding false positives.

This new combination of tests can spare patients unnecessary high-risk surgical procedures, the authors say.

Accurate differentiation of pancreatic cystic lesions is important for early detection and prevention of pancreatic cancer, as well as avoidance of unnecessary surgical intervention. Serous cystic neoplasms (SCNs) have no malignant potential, but can mimic the following premalignant mucinous cystic lesions: mucinous cystic neoplasm and intraductal papillary mucinous neoplasm (IPMN). We recently identified vascular endothelial growth factor (VEGF)-A as a novel pancreatic fluid biomarker for SCN. We hypothesize that combining cyst fluid CEA with VEGF-A will improve the diagnostic accuracy of VEGF-A.