Endoscopic Ultrasonography and Cystic Fluid Analysis of the Pancreas: Evidence of Diagnostic Measures

Endoscopic ultrasonography (EUS) is a highly sensitive test for the detection of cystic lesions of the pancreas. EUS-guided fine-needle aspiration provides cystic fluid for analysis of a variety of tumor markers. The level of carcinoembryonic antigen in the cystic fluid has been reported to be the most accurate marker to distinguish mucinous and nonmucinous pancreatic cystic lesions. Cystic fluid cytology, although the sensitivity is relatively low due to lack of cellular content, is the most accurate test for the diagnosis of a malignant pancreatic cystic lesion. Advances in DNA analysis of pancreatic cystic fluid may provide additional diagnostic information on the lesions.