Next-Generation Sequencing (NGS) in the Prediction of Pancreatic Malignancy: Does Cell Free Mean Error Free?

Excerpt

The prevalence of pancreatic cysts incidentally detected in the general population is reportedly high (~ 49.1%) with their number and size increasing with age [1]. Pancreatic cysts commonly encountered in clinical practice include serous cystadenomas (SCAs), mucinous cystic neoplasms (MCNs), and intraductal papillary mucinous neoplasm (IPMNs). The management of the pancreatic cysts usually depends on their type; SCAs with a low malignant potential require minimal or no surveillance in the absence of symptoms. Surgical resection is recommended for low-grade neoplasms including solid-pseudopapillary neoplasms (SPN). Although follow-up is recommended by a few groups for asymptomatic MCNs, surgeons favor resection since these cysts have malignant potential, requiring long periods of close surveillance. Surgery is recommended for IPMNs involving the main pancreatic duct due to a greater risk of malignant transformation. In contrast, there is a much lower risk of malignancy in branch duct-type IPMNs where there is no involvement of the main duct; close surveillance is usually recommended, with surgery advised only in the presence of certain high-risk criteria [2]. …