Background:
Cystic lesions of the pancreas (CLP) represent a relatively common pathologic entity affecting at least 1% of medical patients and represent a spectrum of lesions from inflammatory pseudocyststo malignant neoplasms. A significant percentage of these cysts are found incidentally during imaging work-up for unrelated conditions and require appropriate diagnostic testing to characterize the nature of the CLP. A multi-disciplinary approach to characterize CLP is currently used involving cytology, imaging, and cyst fluid analysis. The most recent international guidelines recommend resection of pancreatic mucinouscysts \u3e3 cm, or smaller cysts with positive cytology, mural nodules, or symptoms.
Recent work utilized DNA analysis to characterize CLP as either mucinousor serous, and assess malignant potential. Focusing on k-rasgene point mutation, this group was able to detect mucinousdifferentiation (specificity 96%). Further, high amplitude k-rasmutations combined with allelic loss were 96% specific for malignancy. Correlation of k-rasmutation / allelic imbalances with CEA, however, showed poor agreement in the diagnosis of mucinousCLP.
Our aim is to determine the added benefit of molecular testing in diagnosing small (≤3 cm) pancreatic cysts
