الفهرس 
The role of interleukin 1 beta in differentiating malignant from benign pancreatic cysts
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Abstract
Background and Aim: There is increase in the frequency of detection of pancreatic cystic lesions (PCLs) because of the widespread use of cross-sectional imaging reaching up to 13.5% of the patients undergoing magnetic resonance imaging for reasons unrelated to the pancreas. The aim of this study is to evaluate the role of cyst fluid interleukin 1 beta (IL1b) and different endoscopic ultrasound features in differentiating premalignant/malignant from benign pancreatic cysts. Also, to evaluate the role of pancreatic cyst fluid amylase in differentiating true from inflammatory cysts and carcinoembryonic antigen (CEA) in differentiating mucinous from non-mucinous pancreatic cysts. Methods: This prospective multicenter study was conducted on 73 patients with pancreatic cystic lesions. Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) was done. The aspirated specimens were subjected to cytopathological examination (including mucin staining) and estimation of IL1b, amylase and CEA levels. We compared these data with the final diagnosis and follow up of the patients for at least 6 months was done. Results: Pancreatic cyst fluid IL1b level couldn{u2019}t differentiate between premalignant/malignant and benign pancreatic cysts. At a cut off value of 250 U/L, pancreatic cyst fluid amylase level has sensitivity of 46.7% and specificity 67.9% in differentiating true from inflammatory pancreatic cysts with overall accuracy of 54.8%. At a cut off value of 192 ng/mL, pancreatic cyst fluid CEA level has sensitivity of 46.4% and specificity 91.1% in differentiating mucinous from non-mucinous pancreatic cysts with overall accuracy of 74%. Regarding EUS, it can differentiate between premalignant/malignant pancreatic cysts and benign cysts with a sensitivity of 66.7%, specificity of 69.2% and overall accuracy of 68.2%