Table 5. Summary of protein-based biomarkers for cyst-fluid analysis.
| Year | First author | Biomarker | Sample size | Sample distribution | Phase | Observations |
|---|---|---|---|---|---|---|
| 2008 | Schmidt et al.56 | Prostaglandin E2 | 58 | 29 IPMN 11 MCN 12 PDAC 6 Non-Mucinous | 2 | Prostaglandin E2 was elevated in IPMNs compared with MCNs |
| 2010 | Haab et al.57 | Glycosylation Variants | 53 | 32 Mucinous 21 Non-mucinous | 2 | Glycan variant MUC5AC sensitivity 78% specificity 80% for mucinous cysts |
| 2010 | Morris-Stiff et al.64 | Mucin | 128 | 86 Mucinous 42 Non-mucinous | 2 | Mucinous cysts: sensitivity 80% specificity 40%, when combined with CEA, sensitivity 83% specificity 65% |
| 2011 | Maker et al.65 | MUC1, MUC2, MUC4, MUC5AC | 40 | 21 LGD IPMN 19 HGD/Cancer IPMN | 2 | MUC 2 & 4 elevated in HGD IPMN compared with LGD IPMN. Intestinal type had increased expression of MUC2 |
| 2011 | Doyle et al.60 | TGF-alpha | 46 | 26 IPMN 9 MCN 6 SCN 5 PC | 1 | Only IPMN cysts had any levels above 95 pg/ml |
| 2011 | Maker et al.61 | Cytokine Panel Assay | 40 | 21 LGD IPMN 19 HGD/Cancer IPMN | 1 | IL—1beta had high diagnostic accuracy (ROC 0.92) for HGD/Cancer IPMNs compared with LGD IPMNs |
| 2012 | Tun et al.58 | Amphiregulin | 33 | 12 Malignant 15 Mucinous 6 Benign non-mucinous | 1 | Level>300 pg/ml sensitivity 83%, specificity 73% for malignancy (ROC 0.76) |
| 2013 | Cao et al.66 | MUC5AC-WGA, MUC5AC-BGH, Endorepellin-WGA | 44 | 27 Mucinous 17 Non-mucinous | 1 | Mucinous: sensitivity 89% specificity 100% |
| 2013 | Raty et al.67 | SPINK1 | 61 | 33 Mucinous 28 Non-mucinous | 2 | Surgically recommended lesions (MCN and main duct IPMN) vs. SCA or branch-duct IPMN=ROC 0.94 |
| 2014 | Jabbar et al.59 | MUC1 | 29 | 16 Malignant 13 Non-malignant | 2 | Malignancy: sensitivity 87.5% and specificity 92.3% |
| 2014 | Das et al.62 | mAb Das-1 | 38 | 27 IPMN 11 Non-mucinous | 1 | High-Risk IPMNs: Sensitivity 89% specificity 100% (High risk=IPMN-gastric with HGD, any IPMN-intestinal, and IPMN-pancreatico-biliary, any IPMN-oncocytic, and invasive IPMN.) |
| 2014 | Yip-Schneider et al.63 | VEGF | 87 | 17 SCN 70 Non-SCN | 2 | VEGF-A had an ROC of >0.99 for SCNs. With a cutoff set at 8,500 pg/ml, VEGF-A provides 100% sensitivity and 97% specificity as a biomarker for benign SCN lesions. VEGF-C had a similar diagnostic performance |
CEA, carcinoembryonic antigen; IPMN, intraductal papillary mucinous neoplasms; MCN, mucinous cystic neoplasms; PDAC, pancreatic ductal adenocarcinoma; ROC, region of interest; SCN, serous cystic neoplasms; TGF, transforming growth factor; VEGF, vascular endothelial growth factor.