Original articleClinical endoscopyPerformance characteristics of molecular (DNA) analysis for the diagnosis of mucinous pancreatic cysts
Section snippets
Methods
This prospective cohort study was approved by the Indiana University Health Institutional Review Board. All authors had access to the study data and had reviewed and approved the final manuscript. Consecutive patients referred for EUS-FNA of pancreatic cysts were enrolled.
EUS-FNA
The following EUS findings were documented: the location of pancreatic cysts and the number, size, morphology (septations, mural nodules, associated mass), and main pancreatic duct features. EUS-FNA was performed by using a 19-, 22-, or 25-gauge needle (Echotip; Cook Medical, Winston-Salem, NC). Cysts were aspirated until collapse whenever possible. Intravenous antibiotics were given after EUS followed by a 3- to 5-day course of oral antibiotics. Cyst fluid was sent for cytologic examination,
Results
Between April 2008 and October 2011, 453 consecutive patients referred to our institution for EUS-FNA of pancreatic cysts evident on cross-sectional imaging were prospectively enrolled. There were 167 excluded after informed consent was obtained (Fig. 1). Our study population comprised 286 patients (190 females, 67%) with mean age of 64.1 years (±13.9). The baseline demographic, clinical, and imaging characteristics of patients included in the study are shown in Table 1. Surgical pathology was
Discussion
Accurate identification of MPCs is important because of their malignant potential and the need to consider surgery in high malignancy risk cysts or periodic imaging surveillance in low-risk ones. The consensus statement for the management of IPMNs initially published in 2006 and updated recently identified select groups of patients with high-risk features associated with malignant progression.15, 17 These guidelines advocated resection of all IPMNs with main duct involvement, in addition to
Acknowledgments
The authors acknowledge the efforts of Dr Ihab El Hajj in data collection.
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DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: Dr DeWitt receives research support from RedPath Integrated Pathology; Dr Schmidt is a speaker and consultant for RedPath Integrated Pathology. All other authors disclosed no financial relationships relevant to this publication. Dr Al-Haddad (PI, 2008-2010)is the recipient of an American Society for Gastrointestinal Endoscopy (ASGE) Career Development Award.
If you would like to chat with an author of this article, you may contact Dr Al-Haddad at [email protected].