Clinical Utility

Video: Managing Patients With Pancreatic Cystic Lesions

The National Pancreatic Cyst Registry Study1,4

  • Integrated Molecular Pathology (PancraGEN) is intended to be an adjunct to first line testing
  • When used as adjuvant to EUS/FNA testing, PancraGEN can reduce the number of unnecessary surgeries while also providing assurance in surveillance strategies of patients
  • Real world intervention and surveillance decisions were highly associated with PancraGEN diagnostic recommendations
  • PancraGEN diagnoses were more predictive of real world management decisions, benefiting overall patient outcomes more than sole reliance on ICG criteria

Pancreatic Cyst Dilemmas:
From Guidelines to Molecular Markers

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Utility of Molecular Markers

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Limitations and Disclaimers1

Although PancraGEN is highly specific for malignancy, some malignant cysts may not be detected. There may also be individuals who are falsely identified as having a malignant cyst. Diagnosis and appropriate patient management are the responsibility of the referring physician or health care provider.

References

  1. Al-Haddad MA, Kowalski T, Siddiqui A, et al. Integrated molecular pathology accurately determines the malignant potential of pancreatic cysts. Endoscopy. 2015;47(2):136-146.
  2. V. Chernyak et al, Incidental pancreatic cystic lesions Radiology 2015 274 161-9
  3. BU Wu, et al, Prediction of malignancy in cystic neoplasms of the pancreas: a population based cohort study, Am J Gastro 2014 109 121-9
  4. Loren D, Kowalski T, Siddiqui A, et al. Influence of integrated molecular pathology test results on real-world management decisions for patients with pancreatic cysts: analysis of data from a national registry cohort. Diagnostic Pathology. 2016;11:5. doi:10.1186/s13000-016-0462-x.
  5. Gaujoux S., , Brennan, M., et al. Cystic Lesions of the Pancreas: Changes in the Presentation and Management of 1,424 Patients at a Single Institution over a 15-year Time Period. J Am Coll Surg. 2011 April; 212(4): doi:10.1016/j.jamcollsurg.2011.01.016.
  6. Kaimalkliotis, P., Riff, B., et al. Sendai and Fukuoka Consensus Guidelines Identify Advanced Neoplasia in Patients With Suspected Mucinous Cystic Neoplasms of the Pancreas. Clinical Gastroenterology and Hepatology 2015;13:1808–1815: doi:10.1016/j.cgh.2015.03.017
  7. Kushnir VM, Mullady DK, Das K, et al. J Clin Gastroenterol. 2019;53(9):686-692. DOI: 10.1097/MCG.0000000000001118.
  8. Gonda TA, Viterbo D, Gausman V, et al. Clin Gastroenterol Hepatol. 2017;15:913-919.