Stratifying intraductal papillary mucinous neoplasms by cyst fluid analysis: Present and future

Scarlett Hao, Caitlin Takahashi, Rebecca A. Snyder, Alexander A. Parikh

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations

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 significant perioperative morbidity. Efforts have been made to stratify the potential risk of malignancy based on the clinical and radiographic features of IPMN to delineate which cysts warrant resection versus observation. An analysis of the cyst fluid obtained by preoperative endoscopic examination appears to be correlative of cyst type and risk, whereas serum markers and radiographic findings have not yet reached 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 promise in effectively stratifying high-risk versus low-risk lesions. While new cyst fluid markers continue to be identified, additional efforts in testing panels and marker composites in conjunction with clinical 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 of low-risk lesions and to evaluate the new markers detected by proteomics and genetic sequencing.

Original languageEnglish (US)
Article number1147
JournalInternational journal of molecular sciences
Volume21
Issue number3
DOIs
StatePublished - Feb 1 2020
Externally publishedYes

Keywords

  • Cyst fluid analysis
  • Genetic changes
  • Genomics/proteomics/lipidomics
  • Intraductal papillary mucinous neoplasms

ASJC Scopus subject areas

  • Molecular Biology
  • Spectroscopy
  • Catalysis
  • Inorganic Chemistry
  • Computer Science Applications
  • Physical and Theoretical Chemistry
  • Organic Chemistry

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