Pancreatic Cyst Fluid Glucose in Diagnosis of Mucinous Pancreatic Cysts

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A study was carried out to perform a systematic review and meta-analysis to evaluate the diagnostic characteristics of pancreatic cyst fluid glucose, compared with CEA for pancreatic cystic lesions. Individualized searches were developed in accordance with preferred reporting items for systematic reviews and meta-analyses and meta-analysis of observational studies and epidemiologic guidelines and meta-analysis analyzed according to Cochrane diagnostic test accuracy working group methodology. A bivariate model was used to compute pooled sensitivity and specificity, likelihood ratio, diagnostic odds ratio and summary, receiving operating characteristics curve for intracystic glucose or CEA alone or in combination testing.

Eight studies (609 lesions), mean patient age 63.56 years; 60.36% women were included. The pooled sensitivity for pancreatic cyst fluid glucose was significantly higher compared with CEA alone (91%), with no difference in specificity (86%).  Diagnostic accuracy was significantly higher for pancreatic cyst fluid glucose vs CEA alone (94% vs 85%). Combination testing with pancreatic cyst fluid glucose and CEA did not improve the diagnostic accuracy, compared with glucose alone (97% vs 94%).  It was concluded that low pancreatic cyst fluid glucose was associated with high sensitivity and specificity with significantly improved diagnostic accuracy, compared with CEA alone, with a diagnosis of mucinous vs nonmucinous pancreatic cyst lesion.

McCarty, C., Garg, R., Rustagi, T. “Pancreatic Cyst Fluid Glucose in Differentiating Mucinous From Nonmucinous Pancreatic Cysts: A Systematic Review and Meta-Analysis.”  Gastrointestinal Endoscopy 2021; Vol. 94, pp. 698-712.

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