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. 1994 Feb;219(2):131–134. doi: 10.1097/00000658-199402000-00004

Expression of CA 72-4 (TAG-72) in the fluid contents of pancreatic cysts. A new marker to distinguish malignant pancreatic cystic tumors from benign neoplasms and pseudocysts.

A J Alles 1, A L Warshaw 1, J F Southern 1, C C Compton 1, K B Lewandrowski 1
PMCID: PMC1243114  PMID: 8129483

Abstract

OBJECTIVE: The authors evaluated cyst fluid CA 72-4 as a tumor marker in the differential diagnosis of pancreatic cystic lesions. SUMMARY BACKGROUND DATA: Pancreatic cystic lesions include inflammatory pseudocysts, serious cystadenomas, and mucinous tumors. Mucinous tumors can be further subdivided into mucinous cystadenocarcinomas and premalignant mucinous cystic neoplasms. The clinical and radiologic features of these lesions are unreliable to make a preoperative diagnosis of these diagnostically difficult lesions. Analysis of aspirated cyst fluid was proposed as an aid to making the preoperative differential diagnosis. Currently, a number of parameters have been reported as useful markers in cyst fluid aspirates, including the tumor markers carcinoembryonic antigen and CA 15.3, enzymes (amylase, lipase, and amylase isoenzymes), relative viscosity, and cytologic analysis. However, owing to the rarity of pancreatic cystic tumors, experience with cyst fluid analysis is limited. To define additional markers that might be useful in the differential diagnosis of pancreatic cysts, the authors measured the tumor-associated glycoprotein 72 (TAG-72) in aspirates from 19 pancreatic cystic lesions. METHODS: Cyst fluid from 19 pancreatic cysts was obtained by needle aspiration. The tumor marker TAG-72 was measured by a commercial (CA 72-4) immunoassay. RESULTS: Cyst fluid CA 72-4 levels in mucinous cystadenocarcinomas were markedly elevated (mean, 10,027 U/mL; range, 780 to 34,853 U/mL) compared with that in pseudocysts (mean, 3.8 U/mL; range, < 3 to 5.7 U/mL) and serous cystadenomas (mean and range, < 3 U/mL; p < 0.001). The level of CA 72-4 in benign mucinous cystic neoplasms was intermediate (mean, 44.2 U/mL; range, < 3 to 137 U/mL), but it was statistically different from either carcinomas (p = 0.009) or benign cysts (p < 0.001).

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Selected References

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  1. Compagno J., Oertel J. E. Microcystic adenomas of the pancreas (glycogen-rich cystadenomas): a clinicopathologic study of 34 cases. Am J Clin Pathol. 1978 Mar;69(3):289–298. doi: 10.1093/ajcp/69.1.289. [DOI] [PubMed] [Google Scholar]
  2. Compagno J., Oertel J. E. Mucinous cystic neoplasms of the pancreas with overt and latent malignancy (cystadenocarcinoma and cystadenoma). A clinicopathologic study of 41 cases. Am J Clin Pathol. 1978 Jun;69(6):573–580. doi: 10.1093/ajcp/69.6.573. [DOI] [PubMed] [Google Scholar]
  3. Gero E. J., Colcher D., Ferroni P., Melsheimer R., Giani S., Schlom J., Kaplan P. CA 72-4 radioimmunoassay for the detection of the TAG-72 carcinoma-associated antigen in serum of patients. J Clin Lab Anal. 1989;3(6):360–369. doi: 10.1002/jcla.1860030609. [DOI] [PubMed] [Google Scholar]
  4. Johnson V. G., Schlom J., Paterson A. J., Bennett J., Magnani J. L., Colcher D. Analysis of a human tumor-associated glycoprotein (TAG-72) identified by monoclonal antibody B72.3. Cancer Res. 1986 Feb;46(2):850–857. [PubMed] [Google Scholar]
  5. Kornek G. V., Depisch D., Rosen H. R., Temsch E. M., Scheithauer W. Comparative analysis of CA72-4, CA195 and carcinoembryonic antigen in patients with gastrointestinal malignancies. J Cancer Res Clin Oncol. 1992;118(4):318–320. doi: 10.1007/BF01208623. [DOI] [PubMed] [Google Scholar]
  6. Lan M. S., Bast R. C., Jr, Colnaghi M. I., Knapp R. C., Colcher D., Schlom J., Metzgar R. S. Co-expression of human cancer-associated epitopes on mucin molecules. Int J Cancer. 1987 Jan 15;39(1):68–72. doi: 10.1002/ijc.2910390112. [DOI] [PubMed] [Google Scholar]
  7. Lewandrowski K. B., Southern J. F., Pins M. R., Compton C. C., Warshaw A. L. Cyst fluid analysis in the differential diagnosis of pancreatic cysts. A comparison of pseudocysts, serous cystadenomas, mucinous cystic neoplasms, and mucinous cystadenocarcinoma. Ann Surg. 1993 Jan;217(1):41–47. doi: 10.1097/00000658-199301000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Nishida K., Shiga K., Kato K., Kunihiro K., Fujii T., Tomii T., Yamamoto H., Yamane E., Nishioka B., Yoshikawa T. Two cases of pancreatic cystadenocarcinoma with elevated CA 19-9 levels in the cystic fluid in comparison with two cases of pancreatic cystadenoma. Hepatogastroenterology. 1989 Dec;36(6):442–445. [PubMed] [Google Scholar]
  9. Pinto M. M., Meriano F. V. Diagnosis of cystic pancreatic lesions by cytologic examination and carcinoembryonic antigen and amylase assays of cyst contents. Acta Cytol. 1991 Jul-Aug;35(4):456–463. [PubMed] [Google Scholar]
  10. Schwerk W. B. Ultrasonically guided percutaneous puncture and analysis of aspirated material of cystic pancreatic lesions. Digestion. 1981;21(4):184–192. doi: 10.1159/000198561. [DOI] [PubMed] [Google Scholar]
  11. Tatsuta M., Iishi H., Ichii M., Noguchi S., Yamamoto R., Yamamura H., Okuda S. Values of carcinoembryonic antigen, elastase 1, and carbohydrate antigen determinant in aspirated pancreatic cystic fluid in the diagnosis of cysts of the pancreas. Cancer. 1986 May 1;57(9):1836–1839. doi: 10.1002/1097-0142(19860501)57:9<1836::aid-cncr2820570922>3.0.co;2-d. [DOI] [PubMed] [Google Scholar]
  12. Warshaw A. L., Compton C. C., Lewandrowski K., Cardenosa G., Mueller P. R. Cystic tumors of the pancreas. New clinical, radiologic, and pathologic observations in 67 patients. Ann Surg. 1990 Oct;212(4):432–445. doi: 10.1097/00000658-199010000-00006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Warshaw A. L., Rutledge P. L. Cystic tumors mistaken for pancreatic pseudocysts. Ann Surg. 1987 Apr;205(4):393–398. doi: 10.1097/00000658-198704000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Yu H. C., Shetty J. Mucinous cystic neoplasm of the pancreas with high carcinoembryonic antigen. Arch Pathol Lab Med. 1985 Apr;109(4):375–377. [PubMed] [Google Scholar]

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