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The Use of Integrated Molecular Testing in the Assessment and Management of Pancreatic Cysts

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Abstract

Purpose of Review

As abdominal imaging becomes more sensitive and regularly used, pancreatic cystic lesions (PCLs) are being diagnosed more frequently. A small but clinically significant minority of these lesions have a predisposition to either harbor malignancy or undergo malignant transformation. This review highlights the current state and performance of cystic fluid biomarkers and how they may be incorporated into management.

Recent Findings

Among the major domains of molecular testing for PCLs, DNA based analyses have demonstrated the highest accuracy in identifying cyst type and have the most data to support their clinical use. However, epigenetic and protein biomarker based molecular assessments have emerged with the potential to complement DNA based approaches. In addition, recent studies have increasingly demonstrated the value associated with combinations of mutations and other biomarkers in identifying higher grade mucinous cystic lesions.

Summary

We present the performance of individual biomarkers in cyst fluid analysis with an emphasis on an algorithmic approach to improve the accurate identification of both cyst type and risk of malignant transformation.

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Authors and Affiliations

  1. NYU Grossman School of Medicine, 550 1st Ave., New York, NY, 10016, USA

    Joshua D. Kirschenbaum

  2. NYU Langone Department Internal Medicine, Division of Gastroenterology, 240 East 38th Street, 23rd Floor, New York, NY, 10016, USA

    Tamas A. Gonda

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Kirschenbaum, J.D., Gonda, T.A. The Use of Integrated Molecular Testing in the Assessment and Management of Pancreatic Cysts. Curr Gastroenterol Rep 25, 182–190 (2023). https://doi.org/10.1007/s11894-023-00877-6

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