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Pancreatic Neoplasms: HELP
Articles by Scott Dolejs
Based on 2 articles published since 2010
(Why 2 articles?)
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Between 2010 and 2020, Scott Dolejs wrote the following 2 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Article Pancreatic cyst fluid glucose: rapid, inexpensive, and accurate diagnosis of mucinous pancreatic cysts. 2018

Carr, Rosalie A / Yip-Schneider, Michele T / Simpson, Rachel E / Dolejs, Scott / Schneider, Justine G / Wu, Huangbing / Ceppa, Eugene P / Park, Walter / Schmidt, C Max. ·Department of Surgery, Indiana University School of Medicine, Indianapolis, IN; Indiana University Health Pancreatic Cyst and Cancer Early Detection Center, Indianapolis, IN. · Department of Surgery, Indiana University School of Medicine, Indianapolis, IN; Indiana University Health Pancreatic Cyst and Cancer Early Detection Center, Indianapolis, IN; Walther Oncology Center, Indianapolis, IN; Indiana University Cancer Center, Indianapolis, IN. Electronic address: myipschn@iupui.edu. · Department of Surgery, Indiana University School of Medicine, Indianapolis, IN. · Department of Surgery, Indiana University School of Medicine, Indianapolis, IN; Indiana University Health Pancreatic Cyst and Cancer Early Detection Center, Indianapolis, IN; Indiana University Cancer Center, Indianapolis, IN. · Department of Medicine, Stanford University, Stanford, CA. · Department of Surgery, Indiana University School of Medicine, Indianapolis, IN; Indiana University Health Pancreatic Cyst and Cancer Early Detection Center, Indianapolis, IN; Walther Oncology Center, Indianapolis, IN; Indiana University Cancer Center, Indianapolis, IN; Department of Biochemistry/Molecular Biology, Indiana University School of Medicine, Indianapolis, IN. Electronic address: maxschmi@iupui.edu. ·Surgery · Pubmed #29241991.

ABSTRACT: BACKGROUND: The most widely accepted biochemical test for preoperative differentiation of mucinous from benign, nonmucinous pancreatic cysts is cyst fluid carcinoembryonic antigen. However, the diagnostic accuracy of carcinoembryonic antigen ranges from 70% to 86%. Based on previous work, we hypothesize that pancreatic cyst fluid glucose may be an attractive alternative to carcinoembryonic antigen. METHODS: Pancreatic cyst fluid was collected during endoscopic or operative intervention. Diagnoses were pathologically confirmed. Glucose and carcinoembryonic antigen were measured using a patient glucometer and automated analyzer/enzyme-linked immunosorbent assay. Sensitivity, specificity, accuracy, and receiver operator characteristic analyses were performed. RESULTS: Cyst fluid samples from 153 patients were evaluated (mucinous: 25 mucinous cystic neoplasms, 77 intraductal papillary mucinous neoplasms, 4 ductal adenocarcinomas; nonmucinous: 21 serous cystic neoplasms, 9 cystic neuroendocrine tumors, 14 pseudocysts, 3 solid pseudopapillary neoplasms). Median cyst fluid glucose was lower in mucinous versus nonmucinous cysts (19 vs 96 mg/dL; P < .0001). With a threshold of ≤ 50 mg/dL, cyst fluid glucose was 92% sensitive, 87% specific, and 90% accurate in diagnosing mucinous pancreatic cysts. In comparison, cyst fluid carcinoembryonic antigen with a threshold of >192 ng/mL was 58% sensitive, 96% specific, and 69% accurate. Area under the curve for glucose and CEA were similar at 0.91 and 0.92. CONCLUSION: Cyst fluid glucose has significant advantages over carcinoembryonic antigen and should be considered for use as a routine diagnostic test for pancreatic mucinous cysts.

2 Article Pancreatic Cyst Fluid Vascular Endothelial Growth Factor A and Carcinoembryonic Antigen: A Highly Accurate Test for the Diagnosis of Serous Cystic Neoplasm. 2017

Carr, Rosalie A / Yip-Schneider, Michele T / Dolejs, Scott / Hancock, Bradley A / Wu, Huangbing / Radovich, Milan / Schmidt, C Max. ·Department of Surgery, Indiana University School of Medicine; Indiana University Health Pancreatic Cyst and Cancer Early Detection Center, Indianapolis, IN. · Department of Surgery, Indiana University School of Medicine; Department of Walther Oncology Center; Indiana University Cancer Center; Indiana University Health Pancreatic Cyst and Cancer Early Detection Center, Indianapolis, IN. · Department of Surgery, Indiana University School of Medicine. · Department of Surgery, Indiana University School of Medicine; Department of Walther Oncology Center; Indiana University Cancer Center. · Department of Surgery, Indiana University School of Medicine; Department of Biochemistry/Molecular Biology, Indiana University School of Medicine; Department of Walther Oncology Center; Indiana University Cancer Center; Indiana University Health Pancreatic Cyst and Cancer Early Detection Center, Indianapolis, IN. Electronic address: maxschmi@iupui.edu. ·J Am Coll Surg · Pubmed #28633941.

ABSTRACT: BACKGROUND: Accurate differentiation of pancreatic cystic lesions is important for pancreatic cancer early detection and prevention as well as avoidance of unnecessary surgical intervention. Serous cystic neoplasms (SCN) have no malignant potential, but may mimic premalignant mucinous cystic lesions: mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm (IPMN). We recently identified vascular endothelial growth factor (VEGF)-A as a novel pancreatic fluid biomarker for SCN. We hypothesize that combining cyst fluid carcinoembryonic antigen (CEA) with VEGF-A will improve the diagnostic accuracy of VEGF-A. METHODS: Pancreatic cyst/duct fluid was collected from consenting patients undergoing surgical cyst resection with corresponding pathologic diagnoses. Pancreatic fluid VEGF-A and CEA levels were detected by ELISA. RESULTS: One hundred forty-nine patients with pancreatic cystic lesions met inclusion criteria. Pathologic diagnoses included pseudocyst (n=14), SCN (n=26), MCN (n=40), low/moderate grade IPMN (n=34), high grade IPMN (n=20), invasive IPMN (n=10) and solid pseudopapillary neoplasm (n=5). VEGF-A was significantly elevated in SCN cyst fluid compared to all other diagnoses (p<0.001). With a threshold of >5,000 pg/ml, VEGF-A alone has 100% sensitivity and 83.7% specificity to distinguish SCN from other cystic lesions. With a threshold of ≤10ng/ml, CEA alone identifies SCN with 95.5% sensitivity and 81.5% specificity. Sensitivity and specificity of the VEGF-A/CEA combination are 95.5% and 100% respectively. The c-statistic increased from 0.98 to 0.99 when CEA was added to VEGF-A alone in the ROC analysis. CONCLUSIONS: Although VEGF-A alone is a highly accurate test for SCN, the combination of VEGF-A with CEA approaches the gold-standard of pathologic diagnosis, thus importantly avoiding false positives. Patients with a positive test indicating benign SCN can be spared a high risk surgical pancreatic resection.