The clinical impact of endoscopic ultrasound-guided fine-needle aspiration on the patients with low-risk pancreatic cystic lesions

Pan, Shubo; Liu, Jie; Guo, Jiefang; Zhu, Qing; Wang, Liangjing; Shi, Xiaohua

doi:10.3389/fonc.2022.961293

Cited by 1 publication

(1 citation statement)

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“…Use of the EUS-FNA procedure has become more widespread, as the information contained within pancreatic cyst fluid has proven valuable ( 21 – 23 ). This section, and the following sections, will focus on EUS-FNA fluid analysis.…”

Section: Current Clinical Diagnostic Toolsmentioning

confidence: 99%

Addressing the unmet clinical need for low-volume assays in early diagnosis of pancreatic cancer

Sheik,

Byers,

Thomas

et al. 2023

Front. Gastroenterol.

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The incidental detection of pancreatic cysts, an opportunity for the early detection of pancreatic cancer, is increasing, owing to an aging population and improvements in imaging technology. The classification of pancreatic cystic precursors currently relies on imaging and cyst fluid evaluations, including cytology and protein and genomic analyses. However, there are persistent limitations that obstruct the accuracy and quality of information for clinicians, including the limited volume of the complex, often acellular, and proteinaceous milieu that comprises pancreatic cyst fluid. The constraints of currently available clinical assays lead clinicians to the subjective and inconsistent application of diagnostic tools, which can contribute to unnecessary surgery and missed pancreatic cancers. Herein, we describe the pathway toward pancreatic cyst classification and diagnosis, the volume requirements for several clinically available diagnostic tools, and some analytical and diagnostic limitations for each assay. We then discuss current and future work on novel markers and methods, and how to expand the utility of clinical pancreatic cyst fluid samples. Results of ongoing studies applying SERS as a detection mode suggest that 50 µL of pancreatic cyst fluid is more than sufficient to accurately rule out non-mucinous pancreatic cysts with no malignant potential from further evaluation. This process is expected to leave sufficient fluid to analyze a follow-up, rule-in panel of markers currently in development that can stratify grades of dysplasia in mucinous pancreatic cysts and improve clinical decision-making.

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Section: Current Clinical Diagnostic Toolsmentioning

confidence: 99%