University of California, Los Angeles
Molecular Testing of Pancreatic Cystic Neoplasms: Enhancing the Malignant Yield of Pancreatectomy
Overview
Aim: Early Diagnosis / Detection
Pancreatic cysts encompass a range of clinical entities that are commonly discovered incidentally on cross sectional imaging. In the general population, they are identified in 2.5% of individuals. Pancreatic cysts range from benign to malignant. It is imperative to identify which type of pancreatic cyst a patient has and the potential for the pancreatic cyst to develop into cancer. While most of these cysts will not progress to cancer, a detailed workup, including endoscopic ultrasound (EUS) with fine needle aspiration (FNA) with cyst fluid analysis, is necessary to evaluate for malignancy. Depending on the results of these tests and the likelihood of cancer, a decision is made to proceed with surgery or wait and continue surveillance of the cyst with imaging tests. Currently 80% of pancreatic cysts that undergo resection have no evidence of malignancy. There is a need for better diagnostic tools to discriminate malignant and/or high-risk lesions from benign and low risk pancreatic cystic neoplasms so patients with low-risk lesions do not need to undergo unnecessary surgery. The purpose of this study is to investigate the role of a new molecular (74 gene assay) test on pancreatic cyst fluid that differentiates pancreatic cysts as low-risk for cancer or high-risk for cancer. With this information we hope to be able to more accurately identify patients who can be safely watched without surgery and identify those who require surgery.