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Open AccessReview

Stratifying Intraductal Papillary Mucinous Neoplasms by Cyst Fluid Analysis: Present and Future

1
Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC 27834, USA
2
Division of Surgical Oncology, Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC 27834, USA
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2020, 21(3), 1147; https://doi.org/10.3390/ijms21031147
Received: 21 January 2020 / Revised: 4 February 2020 / Accepted: 6 February 2020 / Published: 9 February 2020
(This article belongs to the Special Issue Cell and Molecular Biology of Pancreatic Disorders 2019)
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. View Full-Text
Keywords: intraductal papillary mucinous neoplasms; cyst fluid analysis; genetic changes; genomics/proteomics/lipidomics intraductal papillary mucinous neoplasms; cyst fluid analysis; genetic changes; genomics/proteomics/lipidomics
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MDPI and ACS Style

Hao, S.; Takahashi, C.; Snyder, R.A.; Parikh, A.A. Stratifying Intraductal Papillary Mucinous Neoplasms by Cyst Fluid Analysis: Present and Future. Int. J. Mol. Sci. 2020, 21, 1147. https://doi.org/10.3390/ijms21031147

AMA Style

Hao S, Takahashi C, Snyder RA, Parikh AA. Stratifying Intraductal Papillary Mucinous Neoplasms by Cyst Fluid Analysis: Present and Future. International Journal of Molecular Sciences. 2020; 21(3):1147. https://doi.org/10.3390/ijms21031147

Chicago/Turabian Style

Hao, Scarlett; Takahashi, Caitlin; Snyder, Rebecca A.; Parikh, Alexander A. 2020. "Stratifying Intraductal Papillary Mucinous Neoplasms by Cyst Fluid Analysis: Present and Future" Int. J. Mol. Sci. 21, no. 3: 1147. https://doi.org/10.3390/ijms21031147

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