ÑOMPARATIVE CHARACTERISTICS OF DIAGNOSTIC METHODS OF CYSTIC NEOPLASMS OF THE PANCREAS

Summary. A prospective randomized study was performed which included 99 patients with histologically- confirmed cystic pancreatic formations. Patients were divided into two representative groups by gender and age, distinguished by radiological and laboratory criteria for probable pseudocyst and cystic neoplasms. With sonographic and radiological signs of cystic neoplasms considered the presence of membranes and a solid component in cystic cavities, no calcification in the parenchyma and pancreatic ducts and normal diameter of the main pancreatic duct. The concentrations of tumor markers CEA, CA-125, CA-19.9, and cytological examination were evaluated in fine needle aspirate from the pancreatic cyst. To determine the reliability of the results calculated sensitivity and specificity of each method of diagnosis. As a diagnostic “golden standard” examination of wall of cystic formation was used. Patients with suspected cystic neoplasms of the pancreas, according to preoperative examination were operated (36 patients), but the diagnosis was confirmed histologically in 24 cases (24%). Among all 99 patients with cystic lesions of the pancreas pseudocyst were diagnosed in 63 prior to surgery, but according to postoperative morphological studies pseudocyst was diagnosed in 75 patients. Among cystic neoplasms ? cystoadenoma determined in 3 patients (12%), cystadenocarcinoma was confirmed in 17 cases (71%), in 4 patients (17%) borderline cystic tumor was detected. Morphological variations of cystic neoplasms are characterized by diversity: serous cystic neoplasm 2 (8%), mucinous cystic neoplasm ? 6 (25%) intraductal papillary mucinous neoplasm ? 2 patients (8%), solid-pseudopapillary neoplasm ? 3 (13%), cystic degeneration of malignant solid tumors presented in neuroendocrine tumors form in 6 cases (25%) and ductal adenocarcinoma in 5 (21%). The most informative instrumental methods of diagnosis of cystic neoplasms were multislice computed tomography with intravenous strengthening (sensitivity ? 85%, specificity ? 83%) and MRI (sensitivity ? 88%, specificity ? 94%). High concentration of tumor markers CEA and CA -125 were observed in mucinous cyste and cystic intraductal papillary mucinous neoplasm contents. Marker CA-125 and CEA were informative for the diagnosis of mucinous tumors. Cytological examination and determination of tumor markers CA 19.9 in cystic contents were uninformative.