Molecular Diagnostics in the Evaluation of Pancreatic Cysts

Surg Pathol Clin. 2016 Sep;9(3):441-56. doi: 10.1016/j.path.2016.04.008.

Abstract

Within the past few decades, there has been a dramatic increase in the detection of incidental pancreatic cysts. It is reported a pancreatic cyst is identified in up to 2.6% of abdominal scans. Many of these cysts, including serous cystadenomas and pseudocysts, are benign and can be monitored clinically. In contrast, mucinous cysts, which include intraductal papillary mucinous neoplasms and mucinous cystic neoplasms, have the potential to progress to pancreatic adenocarcinoma. In this review, we discuss the current management guidelines for pancreatic cysts, their underlying genetics, and the integration of molecular testing in cyst classification and prognostication.

Keywords: Diagnostics; Genetics; Intraductal papillary mucinous neoplasm; Mucinous cystic neoplasm; Pancreas; Pancreatic ductal adenocarcinoma; Serous cystadenoma; Solid-pseudopapillary neoplasm.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma, Mucinous / genetics
  • Adenocarcinoma, Mucinous / pathology*
  • Biomarkers, Tumor / genetics
  • Carcinoma, Pancreatic Ductal / diagnosis
  • Carcinoma, Pancreatic Ductal / genetics
  • Carcinoma, Pancreatic Ductal / pathology
  • Carcinoma, Papillary / diagnosis
  • Carcinoma, Papillary / genetics
  • Carcinoma, Papillary / pathology
  • Chromogranins / genetics
  • GTP-Binding Protein alpha Subunits, Gs / genetics
  • Humans
  • Incidental Findings
  • Neoplasm Staging
  • Pancreatic Cyst / diagnosis*
  • Pancreatic Cyst / genetics*
  • Pancreatic Cyst / pathology
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / genetics
  • Pancreatic Neoplasms / pathology
  • Pancreatic Pseudocyst / pathology
  • Pathology, Molecular*
  • Prognosis
  • Proto-Oncogene Proteins p21(ras) / genetics

Substances

  • Biomarkers, Tumor
  • Chromogranins
  • KRAS protein, human
  • GNAS protein, human
  • GTP-Binding Protein alpha Subunits, Gs
  • Proto-Oncogene Proteins p21(ras)