Stratifying Intraductal Papillary Mucinous Neoplasms by Cyst Fluid Analysis: Present and Future

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)

Scarlett,Takahashi,Caitlin,Snyder,Rebecca A.,Parikh,Alexander A. Hao (Creator)

Institution

East Carolina University (ECU )

Web Site: http://www.ecu.edu/lib/

Abstract: A significant proportion of patients with intraductal papillary mucinous neoplasms (IPMNs)undergo surgical resection in order to prevent or treat pancreatic cancer at the risk of significantperioperative morbidity. Efforts have been made to stratify the potential risk of malignancy basedon the clinical and radiographic features of IPMN to delineate which cysts warrant resection versusobservation. An analysis of the cyst fluid obtained by preoperative endoscopic examination appearsto be correlative of cyst type and risk, whereas serum markers and radiographic findings have not yetreached a level of sensitivity or specificity that proves they are clinically meaningful. In this review,we investigate the current cyst fluid analysis studies and present those that have shown promisein effectively stratifying high-risk versus low-risk lesions. While new cyst fluid markers continueto be identified, additional efforts in testing panels and marker composites in conjunction withclinical algorithms have also shown promise in distinguishing dysplasia and the risk of malignancy.These should be tested prospectively in order to determine their role in guiding the surveillance oflow-risk lesions and to evaluate the new markers detected by proteomics and genetic sequencing.

Additional Information

Publication

Other

Language: English

Date: 2020

Keywords

intraductal papillary mucinous neoplasms; cyst fluid analysis; genetic changes; genomics/proteomics/lipidomics

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