The role of molecular analysis in the diagnosis and surveillance of pancreatic cystic neoplasms

JOP : Journal of the Pancreas
Megan WinnerTamas A Gonda

Abstract

Molecular analysis of pancreatic cyst fluid obtained by EUS-FNA may increase diagnostic accuracy. We evaluated the utility of cyst-fluid molecular analysis, including mutational analysis of K-ras, loss of heterozygosity (LOH) at tumor suppressor loci, and DNA content in the diagnoses and surveillance of pancreatic cysts. We retrospectively reviewed the Columbia University Pancreas Center database for all patients who underwent EUS/FNA for the evaluation of pancreatic cystic lesions followed by surgical resection or surveillance between 2006-2011. We compared accuracy of molecular analysis for mucinous etiology and malignant behavior to cyst-fluid CEA and cytology and surgical pathology in resected tumors. We recorded changes in molecular features over serial encounters in tumors under surveillance. Differences across groups were compared using Student's t or the Mann-Whitney U test for continuous variables and the Fisher's exact test for binary variables. Among 40 resected cysts with intermediate-risk features, molecular characteristics increased the diagnostic yield of EUS-FNA (n=11) but identified mucinous cysts less accurately than cyst fluid CEA (P=0.21 vs. 0.03). The combination of a K-ras mutation and ≥2 loss of heterozyg...Continue Reading

Citations

Jul 26, 2019·World Journal of Gastroenterology : WJG·Sandra FaiasMarília Cravo
Dec 5, 2019·World Journal of Gastrointestinal Endoscopy·Rintaro HashimotoJason B Samarasena
Feb 25, 2021·World Journal of Gastrointestinal Endoscopy·Raquel Herranz PérezCecilio Santander Vaquero

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