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KRAS in Cyst Fluid Obtained by Endoscopic Ultrasound-Fine-Needle Aspiration in Pancreatic Cystic Lesions: A Systematic Review and Meta-analysis

2019Journal article Restricted access
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dc.contributor.authorFaias, Sandra
dc.contributor.authorPereira, L.
dc.contributor.authorLuís, Ângelo
dc.contributor.authorCravo, Marília
dc.contributor.authorDias Pereira, António
dc.contributor.authorTorres, Joana
dc.date.accessioned2020-01-28T16:26:37Z
dc.date.available2020-01-28T16:26:37Z
dc.date.issued2019
dc.description.abstractTo evaluate the diagnostic accuracy of KRAS mutation in pancreatic cystic fluid and compare it with carcinoembryonic antigen and cytology, we identified studies with cyst fluid obtained by endoscopic ultrasound prior to surgery. We classified cysts as malignant, premalignant, and benign. A random-effects model was used for quantitative meta-analysis. Pooled sensitivities, specificities, and summary receiver operating characteristic curve analysis were conducted. We analyzed 16 studies, with 3429 patients, including 731 referred for surgery. Carcinoembryonic antigen was better for clinically significant cysts (premalignant and malignant) with sensitivity = 0.58 (95% confidence interval [CI], 0.53-0.65), specificity = 0.9 (95% CI, 0.76-0.97), and area under the curve (AUC) = 0.69. Cytology performed better in malignant cysts, with sensitivity = 0.37 (95% CI, 0.27-0.48), specificity = 0.96 (95% CI, 0.93-0.98), and AUC = 0.78. Isolated, KRAS mutation failed the diagnosis of malignant and significant cysts, with sensitivities = 0.43 (95% CI, 0.34-0.43) and 0.46 (95% CI, 0.42-0.51), specificities = 0.62 (95% CI, 0.56-0.68) and 0.97 (95% CI, 0.92-0.99), and AUCs = 0.56 and 0.53, respectively. Carcinoembryonic antigen and cytology are more accurate than KRAS. Additional studies are lacking to recommend KRAS as a single diagnostic test.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.1097/MPA.0000000000001325pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.6/8822
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectCEApt_PT
dc.subjectCytologypt_PT
dc.subjectEUSpt_PT
dc.subjectEUS-FNApt_PT
dc.subjectKRASpt_PT
dc.subjectPancreatic cystpt_PT
dc.titleKRAS in Cyst Fluid Obtained by Endoscopic Ultrasound-Fine-Needle Aspiration in Pancreatic Cystic Lesions: A Systematic Review and Meta-analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage758pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage749pt_PT
oaire.citation.titlePancreaspt_PT
oaire.citation.volume48pt_PT
person.familyNameFaias
person.familyNamePereira
person.familyNameSantos Luís
person.familyNameCravo
person.givenNameSandra
person.givenNameLuísa
person.givenNameÂngelo Filipe
person.givenNameMarília
person.identifier.ciencia-idF415-64BA-F514
person.identifier.ciencia-id4F15-1868-D001
person.identifier.ciencia-id3D14-798B-65D3
person.identifier.orcid0000-0002-3358-7288
person.identifier.orcid0000-0002-9068-4607
person.identifier.orcid0000-0003-0712-6522
person.identifier.orcid0000-0001-8309-4599
person.identifier.scopus-author-id6504523901
person.identifier.scopus-author-id10839238300
person.identifier.scopus-author-id35551480200
rcaap.embargofctCopyright cedido à editora no momento da publicaçãopt_PT
rcaap.rightsclosedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicatione72fb3b6-e1fa-4cd7-bbd8-675b810829ca
relation.isAuthorOfPublication604e508e-9f4e-4950-b2a4-1b06c7192afe
relation.isAuthorOfPublicationa2d7c872-99db-41e1-9bc9-82c2d47b4661
relation.isAuthorOfPublicationd371b63d-92a6-4771-8b4a-913567d1c9d2
relation.isAuthorOfPublication.latestForDiscoverya2d7c872-99db-41e1-9bc9-82c2d47b4661

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