Pancreatic Cyst Fluid Assessment: Updates in Genetic Analysis and Risk for Progression

Given some pancreatic cysts require surveillance due to established malignant potential, efforts are being made to develop precise methods of early detection of advanced pancreatic neoplasia. This review focuses on genetic analysis of pancreatic cyst fluid for early detection of pancreatic cysts at high risk for neoplastic progression. Expanded, targeted next generation sequencing pathways, such as PancreaSeq, are highly sensitive and specific not just for cyst type, but also prognosticating progression to advanced neoplasia. Currently published guidelines aiding in management of pancreatic cyst surveillance have been shown to have inferior diagnostic performance when compared to algorithms involving next-generation sequencing. Recent developments in novel next-generation sequencing pathways involving DNA/RNA based assays have increasingly allowed practitioners highly sensitive and specific modalities for early detection of advanced pancreatic neoplasia.