New criteria to differentiate between mucinous cystic neoplasm and serous cystic neoplasm in pancreas by endoscopic ultrasound: A preliminarily confirmed outcome of 41 patients

BACKGROUND AND OBJECTIVES: The ability to distinguish between mucinous cystic neoplasm (MCN) and serous cystic neoplasm (SCN) in the pancreas preoperatively by endoscopic ultrasound (EUS) remains a clinical challenge. To address this problem, we have developed new criteria using EUS findings and cyst fluid carcinoembryonic antigen (CEA) in the clinic. In this study, the validity and reliability of these criteria were assessed. MATERIALS AND METHODS: Between April of 2015 and May of 2016, a total of 59 patients with pancreatic cystic neoplasms underwent EUS and ultimately received surgery in our hospital. Of the 59 patients, 21 were pathologically verified to have MCN while 20 were verified to have SCN in the pancreas. For these 41 patients with MCN or SCN, EUS findings and cyst fluid CEA were reviewed. RESULTS: For the 41 patients reviewed, the new criteria were found to identify MCN with 85.71% sensitivity (95% confidence interval [CI], 64%–97%), 80.00% specificity (CI, 56%-94%), and 82.93% accuracy (CI, 68%–93%). CONCLUSION: These new criteria were preliminarily found to produce excellent results, with 82.93% accuracy determined for the differential diagnosis between MCN and SCN by EUS. However, a further prospective study with a larger population must be carried out to fully assess these new criteria.