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PubMed1997

Expression of mucin-like carcinoma-associated antigen in the cyst fluid differentiates mucinous from nonmucinous pancreatic cysts.

OBJECTIVES: Differential diagnosis of pancreatic cystic lesions may be difficult: the main problem is to distinguish mucinous neoplasms from nonmucinous cysts. We evaluated the usefulness of the mucin-like carcinoma-associated antigen (MCA) in the fluid of pancreatic cysts for detecting mucinous neoplasms. Results were compared with those of CA 15-3, carcinoembryonic antigen (CEA), and CA 72-4 fluid content, and cytology. METHODS: Twenty-four pancreatic cyst fluids were collected from 10 pseudocysts, eight mucinous cystic tumors, and six serous cystadenomas. RESULTS: MCA was elevated in seven of eight mucinous tumors (sensitivity 87.5%, specificity 100%). A significant difference was found between MCA levels in mucinous neoplasms versus pseudocysts (p = 0.0003) and serous cystadenomas (p = 0.001). Mean MCA levels were higher (133.7 U/ml) in mucinous cystadenocarcinomas than in cystadenomas (37.5 U/ml). The sensitivity of CA 15-3, CEA, and CA 72-4 in detecting mucinous neoplasms was 50, 87.5, and 87.5%, respectively, with a specificity of 94%, 44%, and 94%, respectively. Cytology showed mucinous epithelial cells in only four of eight mucinous neoplasms, with a specificity of 100%. CONCLUSIONS: These data suggest that MCA determination in the cyst fluid is a promising new tumor marker for the preoperative diagnosis of mucinous cystic neoplasms of the pancreas.

Antigens, Neoplasm↗
PubMed2002

Accumulation of 4- and 5-ene steroid sulfates in human breast cyst fluids.

Gross cystic disease of the breast is one of the most common diseases of adult females. Breast cyst fluid contains various steroid hormones. In order to obtain more information about the concentrations of 4- and 5-ene steroids in human breast cyst fluids, levels of pregnenolone sulfate (PREGS), pregnenolone (PREG), dehydroepiandrosterone sulfate (DHEAS) and dehydroepiandrosterone (DHEA) were determined by high-performance liquid chromatography (HPLC). A total of 35 human breast cyst fluid samples, obtained from 35 patients (28-54 years old) were analyzed. Cyst fluid electrolytes were simultaneously determined. Levels of PREGS (mean+/-S.D.) were 26.9+/-20.0 micromol/l (N=35) and of PREG were <0.1 micromol/l. Levels of DHEAS and DHEA were 89.1+/-111.7 micromol/l (N=35) and 0.3+/-0.2 micromol/l (N=35), respectively. Cyst fluids were divided into two groups (types I and II) according to their electrolyte ratio (K(+)/Na(+)). The cysts of the type I group (K(+)/Na(+) >1.5) contained significantly higher levels of PREGS (39.9+/-21.1 micromol/l) and DHEAS (133.2+/-87.9 micromol/l) than those of the type II group (K(+)/Na(+) <1.5), the mean levels of which were 19.8+/-16.2 micromol/dl for PREGS, and 36.3+/-29.0 micromol/dl for DHEAS (P<0.05). PREGS and DHEAS levels in the cysts were significantly correlated (r=0.49; P<0.01). Human breast cyst fluids contain high concentration of DHEAS and PREGS, especially in the cyst fluids containing high K(+)/Na(+) ratios.

Adult↗
PubMed1983

Presence of immunosuppressive factors in brain-tumor cyst fluid.

The present investigation was conducted to examine the effects upon normal lymphocyte activation of the addition of brain-tumor cyst fluid or cerebrospinal fluid (CSF) to an in vitro culture system. It was believed that factors present in these fluids may play a role in local and systemic immunosuppression in brain-tumor patients. The authors evaluated the effect of the cyst fluid, CSF, and serum from eight patients with brain tumors (one astrocytoma, five glioblastoma multiforme, one medulloblastoma, and one microglioma) on mitogen-stimulated lymphocyte function as measured by 3H-thymidine incorporation, cell size distribution, and cellular proliferation. Lymphocytes from normal volunteers were incubated for 90 hours in culture medium with 10% pooled human serum, mitogens (phytohemagglutinin, concanavalin A, and pokeweed mitogen), and a range of volumes of cyst fluid or CSF from the tumor patients. Significant suppression of mitogen-induced activation of the lymphocytes was demonstrated in the presence of cyst fluid from five out of six patients, but the mitogen response was only minimally affected by the addition of the CSF from these patients to the culture medium. The suppression of lymphocyte activation by cyst fluid was directly proportional in several cases to the concentration of the cyst fluid. The total protein, albumin, and immunoglobulin (Ig) concentrations in the cyst fluids were observed to roughly correspond to the serum levels and were much higher than in CSF. These studies suggest that brain-tumor cells locally produce lymphocyte-suppressive factors which may then be released into blood. Preliminary characterization of the suppressive factor(s) responsible for the inhibition of lymphocyte function indicates that they are non-dialyzable and do not appear to be an IgG.

Adolescent↗
PubMed1991

Biochemical and pharmacodynamic studies of simple renal cyst fluids in relation to infection.

Biochemical analysis of renal cyst fluid was performed in 53 patients with simple renal cysts including 2 infected cases. The composition of noninfected cyst fluid tended to parallel that of serum. Additionally, the penetration of amikacin into cyst fluid was studied in 2 infected and in 11 noninfected patients following a single 200-mg intramuscular injection of amikacin. Drug levels in the fluid were below detection limit in the noninfected and approximately half or less of the serum values in the infected patients. These data may explain one of the reasons why infection of simple renal cysts is highly resistant to antimicrobial chemotherapy. The value of treatment by percutaneous aspiration and drainage of infected cysts is emphasized.

Adult↗
PubMed1995

Epidermal growth factor precursor is present in a variety of human renal cyst fluids.

Progressive human renal cystic diseases are characterized by proliferation of the epithelial cells lining the cyst. The kidney synthesizes epidermal growth factor and its presence in renal cyst fluid might contribute to renal epithelial cell proliferation. We screened autosomal dominant polycystic kidney disease, acquired renal cystic disease, the von Hippel-Lindau syndrome, multilocular cystic nephroma, multicystic dysplastic kidney disease and simple cyst fluids for the presence of epidermal growth factor by radioreceptor assay, specific radioimmunoassay, immunoprecipitation and immunoblotting. Multiple epidermal growth factor immunoreactive species of approximately 180 kD. and lower molecular weights were present in almost all cyst fluids examined, suggesting endogenous synthesis and limited proteolysis of epidermal growth factor precursor protein in cyst fluid. Tamm-Horsfall protein was detected by enzyme-linked immunosorbent assay in most cysts (for example 55 of 59 autosomal dominant polycystic kidney disease samples). The majority of simple and autosomal dominant polycystic kidney disease renal cysts contained high sodium ion concentration, epidermal growth factor precursor protein and Tamm-Horsfall protein, characteristic of the early thick ascending limb. Rather than the mere presence of epidermal growth factor in renal cyst fluids, increased sensitivity to epidermal growth factor or other mitogens present in renal cyst fluid may be pathogenic in progressive renal cystic disease.

Epidermal Growth Factor↗
PubMed2003

Gonadotropin (LH, FSH) levels in serum and cyst fluid in epithelial tumors of the ovary.

OBJECTIVES: The aim of this work was to determine gonadotropin (LH, FSH) levels in serum and cyst fluid in various type of ovarian epithelial neoplasms (benign, borderline, malignant) and to compare them with levels in benign cysts. Additionally we decided to estimate if there were some significant correlations between serum and ovarian cyst fluid in gonadotropin levels in all investigated groups. MATERIALS AND METHODS: The study group included 74 patients before (n=36) and after (n=38) menopause, divided into four groups depending on the histopathologic diagnosis. Serum and cyst fluid levels of LH and FSH were determined in all patients. RESULTS: We found statistically significant differences concerning LH and FSH levels in serum and cyst fluid between malignant and borderline tumors, between malignant tumors and benign cystadenomas and between malignant tumors and non-neoplastic cysts. We also found statistically significant correlations between serum and cyst fluid as to FSH and LH levels in patients with borderline tumors. There were no statistically significant correlations between serum and cyst fluid as to FSH and LH levels in patients with malignant epithelial tumors (group 1) and in patients with benign cystadenomas (group 3). CONCLUSIONS: High FSH and LH levels in cyst fluid of malignant epithelial tumors of the ovary are in line with the gonadotropin theory of tumor growth. Simultaneous determination of various types inhibin levels appears to be an interesting topic for our future research.

Adenocarcinoma, Mucinous↗
PubMed1993

Prenatal diagnosis of a placental cyst: comparison of postnatal biochemical analyses of cyst fluid, amniotic fluid, cord serum, and maternal serum.

A 4 x 4 cm placental cyst was diagnosed prenatally by ultrasonography. At delivery, simultaneous samples of cyst fluid, amniotic fluid, cord blood, and maternal blood (collected 3 hours before delivery) were obtained. Biochemical measurements of cyst fluid, amniotic fluid, cord serum, and maternal serum suggest that the solutes of cyst fluid do not originate exclusively from a single source. In addition, X-cell synthesis and secretion into the cyst fluid may occur.

Adolescent↗
PubMed1994

[Concentrations of 17 beta-estradiol, testosterone and progesterone in ovarian cyst fluid and intact ovarian follicles of swine].

The concentrations of 17 beta-oestradiol, testosterone and progesterone were determined in the fluid of ovarian cysts of 80 sows. The cysts were grouped into the following categories: follicle theca cysts, follicle lutein cysts, lutein cysts, blood cysts and mixed forms. By comparison the concentrations of 17 beta-oestradiol, testosterone and progesterone were determined in the fluid of normal follicles of 100 pigs during the dioestrus, prooestrus and oestrus. The concentrations of progesterone were higher in the fluid of cysts of all groups investigated than in the fluid of normal follicles. The concentrations of 17 beta-oestradiol and testosterone were lower in the cyst fluid than in the follicular fluid. There were not serious differences in the hormone profiles of the cyst fluid between the cysts of the different categories.

Animals↗
PubMed1990

Biochemical characterization of glycoprotein components in human ovarian cyst fluids by lectins.

1. Perchloric acid-soluble glycoprotein fractions (PASFs) were separated, in yields of 180-610 mg per 100 ml of cyst fluid, from the cyst fluids of human ovarian cystadenomas (OCAs) in benign and borderline and ovarian clear cell carcinoma (OCC) in malignant, and then identified as glycoproteins with 19.1-69.5% carbohydrate by their chemical composition analyses. 2. These PASFs reacted with anti-A, -B, -Lea and/or -Leb sera, but did not react with anti-H, -M and -N sera. All of the PASFs reacted with Ricinus communis lectin (RCA-I). Among these PASFs, PASFs from the cyst fluids of OCA in benign did not react with Arachis hypogaea anti-T lectin (PNA) and both of the anti-N lectins of Vicia graminea (VGA) and Vicia unijuga (VUA), and PASFs from OCA in borderline reacted with only PNA and PASFs from OCC in malignant reacted with the three lectins, PNA, VGA and VUA. However, none of PASFs from human normal sera and various normal organ tissues reacted with any of RCA, PNA, VGA and VUA. 3. The above-mentioned results seem to show that the examination of glycoproteins of ovarian cyst fluids by the combined use of RCA-I, PNA and VGA (or VUA) permits biochemical diagnosis of the canceration degree of ovarian cystomas.

Adenocarcinoma↗
PubMed2004

Endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of foregut duplication cysts: the value of demonstrating detached ciliary tufts in cyst fluid.

BACKGROUND: The management of foregut duplication cysts is controversial, especially in asymptomatic patients. The safety and accuracy of endoscopic ultrasound (EUS) and EUS-fine-needle aspiration EUS-FNA) in confirming the nature of cysts by using electron microscopy (EM) has not been reported. In this study, the authors describe the utility of demonstrating detached ciliary tufts (DCTs) in the diagnosis of foregut duplication cysts with EUS-FNA. METHODS: Consecutive patients with suspected mediastinal masses or mediastinal cysts on imaging studies were evaluated prospectively by EUS and EUS-FNA. Cyst fluid was examined by routine cytologic techniques. In two patients, EM was performed to confirm the nature of DCTs. RESULTS: Ten consecutive patients were evaluated with EUS and EUS-FNA. Seventy percent of the cysts were characterized by computed tomography (CT) scans as solid masses. The mean greatest cyst dimension measured 34 mm x 48 mm by EUS. Microscopic examination of the cyst content revealed mucinous material, cellular debris, and DCTs. The latter were seen in routine cytologic preparations and by EM. Patients were followed up to a median of 321 days. Due to EUS-FNA confirmatory diagnoses of foregut duplication cysts, none of the patients except 1 underwent surgical resection after developing pneumonia 6 months later. Histologic sections of the resected specimen confirmed the presence of (foregut cyst, bronchogenic type). All other patients were asymptomatic. Cysts size and nature did not change on repeated imaging studies. CONCLUSIONS: EUS was superior compared with CT scanning in characterizing foregut duplication cysts. EUS-FNA is safe and accurate in the diagnosis of foregut duplication cysts. The demonstration of DCTs in cyst fluid and the absence of malignant cells confirmed the benign nature of these lesions, allowing conservative and expectant management for these patients.

Adult↗
PubMed1993

Cyst fluid CA 125 levels in ovarian epithelial neoplasms.

OBJECTIVE: To assess the feasibility of using cyst fluid CA 125 levels to distinguish between benign and malignant ovarian cystic neoplasms. METHODS: CA 125 levels were measured in ovarian cyst fluid and in serum obtained at surgery in 44 women with ovarian cystic tumors of epithelial origin (25 benign, 12 malignant, and seven borderline). RESULTS: The median cyst fluid CA 125 level in malignant neoplasms (671 U/mL) was higher than in benign tumors (175 U/mL), and 86% of the malignant tumors contained levels higher than 100 U/mL in the cyst fluid, compared with only 62% of the benign tumors. However, these differences were not statistically significant. CONCLUSION: Cyst fluid levels of CA 125 cannot be used to distinguish between benign and malignant ovarian cysts of epithelial origin.

Adolescent↗
PubMed1996

Prostate specific antigen--a new constituent of breast cyst fluid.

We demonstrate for the first time that prostate specific antigen (PSA) is a component of breast cyst fluid. At the cutoff level of 0.01 or 0.03 micrograms/L of PSA, 64% or 43% of cyst fluids are positive for PSA, respectively. PSA in cyst fluid, as characterized by high performance liquid chromatography, exists in almost equal concentrations as free PSA, with a molecular weight of 33 KDa, and as PSA bound to alpha 1-antichymotrypsin, with a molecular weight of 100 KDa. PSA presence was also characterized in cyst fluid by Western blot analysis. These data suggest that PSA is a frequent component of breast cyst fluid. More studies are needed to establish the role of this serine protease in normal breast, gross breast cystic disease, and breast cancer.

Adult↗
PubMed1991

Surgical experience with nonparasitic cysts of the liver--the characteristics and constituents of cyst fluid.

Fifteen patients with nonparasitic hepatic cysts underwent surgery to relieve abdominal complaints, at the First Surgical Department, Tokyo University Hospital between 1966 and 1989. Total removal of the cyst was carried out in 14 of the patients, while puncture and aspiration only were performed in the other patient in whom a cyst had ruptured spontaneously, after which hemoperitoneum was observed at emergency laparotomy. The size of the cysts varied from 7-19 cm with a mean of 12.4 cm. Histological study revealed a congenital cyst in 14 patients and a cystadenoma in one. The epithelium lining of the internal surface of the congenital cysts was highly atrophic and desolated and often disappeared. Examination of the cyst fluid revealed the same concentration of electrolytes as in the serum. Hepatic enzyme levels were usually lower than in the serum, but lactic dehydrogenase and aminotransferase levels were elevated in a few cases. Tumor marker levels of the cyst fluid were higher than those in the serum in four of five patients examined.

Adult↗
PubMed1996

Magnetic resonance relaxation time in evaluating the cyst fluid characteristics of endometrioma.

To determine whether the cyst fluid characteristics of endometrioma can be evaluated by magnetic resonance imaging (MRI), 36 endometriomas obtained from 24 patients (age range 21-43 years; mean 34 years) were studied. MRI was performed < 2 weeks before laparoscopy or laparotomy. Comparative studies of the density and concentration of iron in the endometrioma and the signal intensity (SI) of MRI [calculated relaxation time T1 value, calculated relaxation time T2 value, signal intensity on a T1-weighted image (T1SI) and on a T2-weighted image (T2SI) of the cyst; T1SI/signal intensity of the gluteus maximus muscle (MSI), and T2SI/MSI of the cyst] were performed. The density of the cyst fluid and its iron concentration were found to be directly proportional. There was a significant relationship between the concentration of iron and the T2SI, T2SI/MI and calculated T2 values. In particular, the concentration of iron and the ration of T2SI/ MSI were inversely proportional. Therefore, T2SI/MSI reflected the concentration of iron in endometriomas without recourse to measurement of the calculated T2 value, which suggests that the MRI and T2 signal intensity may be useful for evaluating the cyst fluid characteristics of endometriomas.

Adult↗
PubMed1992

Improved "electrophoretic map" of breast cyst fluid proteins.

Human breast cyst fluid (BCF) proteins were evaluated by sodium dodecylsulfate polyacrylamide gel electrophoresis (SDS-PAGE) after protein denaturation in the presence or absence of 2-mercaptoethanol. Both electrophoretic techniques yielded characteristic and reproducible banding patterns and achieved a high degree of resolution. The known four major protein bands were identified; silver-staining procedure resulted in more discrete bands (at least 13). Crossed-immunoelectrophoresis analyses of BCF allowed an improved protein mapping of this pathological fluid, presenting the opportunity of simultaneous quantification and identification of at least 22 proteins. The clinical and biological potential of these electrophoretic methods for detecting BCF proteins is discussed.

Electrophoresis, Polyacrylamide Gel↗
PubMed1992

Categorization of cysts and steroid levels in breast cyst fluid.

Several reports indicate that patients with macrocysts have a two- to fourfold higher risk of developing cancer. The fluid filling the cysts (breast cyst fluid, BCF) contains unusual amounts of biologically active substances, including hormones and metabolites. The accumulation of steroid conjugates, such as androgen and estrogen sulfates, deserves interest. Measuring BCF cations (K+, Na+) permits classification of cysts into two major subsets (type I and type II), conceivably associated with a different degree and with a turnover of apocrine cells in the lining epithelium. Type I (high K+/Na+ ratio) and type II (low K+/Na+ ratio) cysts display different patterns of steroid analytes and steroid-binding proteins. There are many gaps in our understanding of the relationship between local steroids and hypersecretion of fluid in the terminal duct lobular units with eventual appearance of cysts. Accumulating biochemical and epidemiological data, however, point to recurrent, multiple type I cysts as a marker of endocrine risk, i.e., of a whole-organ promoting status toward proliferative premalignant lesions.

Breast Neoplasms↗
PubMedDate not supplied

Prostaglandin E2 and F2 alpha levels in human dental cyst fluid as bone resorbing factors?

Prostaglandin E2 and F2 alpha concentrations in aspirated cyst fluid of 14 human dental cysts were measured by radioimmunoassay. The mean concentrations were found to be 22.0 ng PGE2/g cyst fluid and 4.0 ng PGF2 alpha/g cyst fluid. As compared to plasma conditions a remarkable shift of the ratio of the two prostaglandins to PGE2 could be demonstrated. Due to the high concentrations of PGE2 found in the cyst material it is suggested that this prostaglandin may be one of the bone resorbing factors to be responsible for the destruction of bone in periodontal diseases.

Bone Resorption↗
PubMedDate not supplied

Gonadotropin levels in ovarian cyst fluids: a predictor of malignancy?

Gonadotropins can stimulate ovarian cancer growth in cell cultures. Corresponding LH/hCG receptors have been demonstrated in ovarian cancer. However, reduction of elevated serum gonadotropins by GnRH analogs in ovarian cancer patients did not lead to growth restriction, which means that serum levels of gonadotropins may not play the most important role in ovarian cancer. We therefore analyzed the LH and FSH concentrations in cyst fluids of ovarian cancer. Patients with preoperatively diagnosed cystic ovarian tumors were eligible for the study. Serum samples of the patients were obtained during surgery, while the fluids within the cysts were aspirated after surgical removal of the tumor. FSH and LH levels in serum and cyst fluids were measured using single antibody EIA (Boehringer Mannheim GmbH, Germany). Cyst fluids and sera of 108 patients were evaluated. While there were no significant differences in the FSH and LH serum concentrations, highly significant differences in the FSH and LH levels in cyst fluids were found. Only cancer cysts contained FSH and LH, while the corresponding concentrations in benign cysts were always below the measuring range of the assays. This clear division between high gonadotropin levels in cysts of serous ovarian cancer and low or absent concentrations in benign ovarian tumors further supports the hypothesis that FSH and LH may play a role in ovarian cancer; however, explanations for this surprising finding are still lacking.

Biomarkers, Tumor↗