The role of molecular biology in the differential diagnosis of pancreatic cystic neoplasias

Czech version

Authors: Horný I. ¹; Tomáš Hucl ²
Authors‘ workplace: Interní oddělení, Nemocnice Strakonice, a. s. ¹; Klinika hepatogastroenterologie IKEM, Praha ²
Published in: Gastroent Hepatol 2021; 75(5): 417-423
Category: Original Article
doi: https://doi.org/10.48095/ccgh2021417

Overview

Pancreatic cysts have been detected ever more frequently in recent years due to the advanced and wider use of imaging methods. We find them on CT or MR also in asymptomatic patients who do not have a history of any pancreatic disease. Pancreatic cystic lesions represent a wide range of pathological changes from simple cysts through precancerous lesions to malignant cysts. Accurate diagnosis remains difficult despite the combination of clinical status evaluation, imaging findings, and biochemical and cytological examination. Molecular biological examination of cyst aspirate obtained by endosonographic examination increases the detection rate of mucinous cysts (KRAS/GNAS/VHL) and cysts with a high risk of malignancy (KRAS/GNAS/p53/PIK3CA/PTEN/CDKN2A/SMAD4) and optimizes therapeutic approach. Larger prospective validation studies are necessary to make this costly and limited method a routine part of clinical practice.

Keywords:

molecular biology – neoplasia – pancreatic cysts

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