Publication: Mucin expression in mucinous pancreatic cysts: Can string sign test predict mucin types? A single center pilot study
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Date
2020-12-01T00:00:00Z
Authors
Köker, İbrahim Hakkı
Ünver, Nurcan
Malya, Fatma Ümit
Uysal, Ömer
Şentürk, Hakan
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Abstract
Background: Mucinous pancreatic cystic lesions (PCLs) express different mucin (MUC) types according to their histomorphologic types.
High cystic fluid viscosity may help in the detection of mucinous PCLs. We hypothesized that high cystic fluid viscosity may be suggestive of a certain MUC type in mucinous PCLs.
Methods: Prespecified MUC types (MUC1, MUC2, MUC4, MUC5AC, and MUC6) were evaluated in 18 definitively diagnosed mucinous
PCLs with sufficient tissue material and prediagnostic cyst fluid viscosity evaluation—string sign (SS)—test. We evaluated the agreement of MUC expression with positive SS test results. Later, we compared cystic fluid carcinoembryonic antigen (CEA) between the
prespecified MUC expressing and nonexpressing cyst types.
Results: A total of 18 mucinous PCL patients, 11 females, with mean age ± SD (59.7 ± 13.3) were included. Almost all malignant mucinous PCLs expressed MUC1 (71.4%) (P = .023). We found no significant agreement between the prespecified MUC types and positive
SS, except MUC4 which had mild agreement. Also, no significant relation was found between cystic fluid CEA levels and MUC expression
(P = .584).
Conclusion: We did not detect a significantly moderate or good agreement between the prespecified MUC types and SS test. MUC1 was
highly expressed in malignant mucinous cysts; however, it was incompatible with the SS test. MUC4 expression showed mild agreement
with the SS test in a small number of patients
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Keywords
String sign, Pancreas cyst, MUC, malignancy