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Current Treatment Options in Gastroenterology

Erschienen in:

27.01.2020 | Pancreas (V Chandrasekhara, Section Editor)

Molecular Diagnostics and Testing for Pancreatic Cysts

verfasst von: Jaime de la Fuente, MD, Shounak Majumder, MD

Erschienen in: Current Treatment Options in Gastroenterology | Ausgabe 1/2020

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Abstract

Purpose of review

In current clinical practice, the diagnosis and management of pancreatic cystic lesions (PCLs) are based on guidelines that combine clinical and imaging findings. These guidelines usefully identify a large category of low-risk PCLs that do not require treatment. However, they have limited accuracy for diagnosis of advanced neoplasia in worrisome and high-risk PCLs. Novel molecular markers that can accurately detect advanced neoplasia in PCLs can transform the care of patients with PCLs. We reviewed the recent medical literature on molecular diagnostics of PCLs and summarized molecular biomarkers assayed in cyst fluid, pancreatic juice, and blood.

Recent findings

Several studies have been recently published describing promising early results in genetic, epigenetic, and protein biomarkers from cyst fluid to help in both histologic diagnosis and detection of advanced neoplasia. The majority of studies have been completed using opportunistically collected archival cyst fluid and few report validation in independent sample sets. Results of ongoing multicenter prospective validation studies are awaited and will help define the best combination of cyst fluid molecular markers. In multifocal PCLs communicating with the pancreatic ductal system, a pancreatic juice biomarker is likely to be less invasive and more informative. Novel biomarkers in pancreatic juice and blood are in early phases of study.

Summary

The field of molecular diagnostic biomarkers for PCLs is rapidly evolving with several promising candidate markers being prospectively evaluated. In the near future, these novel molecular markers, combined with advances in imaging technology, will transform clinical decision-making in the management of PCLs and improve patient outcomes.

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Titel: Molecular Diagnostics and Testing for Pancreatic Cysts
verfasst von: Jaime de la Fuente, MD
Shounak Majumder, MD
Publikationsdatum: 27.01.2020
Verlag: Springer US
Erschienen in: Current Treatment Options in Gastroenterology / Ausgabe 1/2020
Print ISSN: 1092-8472
Elektronische ISSN: 1534-309X
DOI: https://doi.org/10.1007/s11938-020-00270-6

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Molecular Diagnostics and Testing for Pancreatic Cysts

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Purpose of review

Recent findings

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