Gastrointest Interv.  2017 Mar;6(1):63-69. 10.18528/gii.170006.

Recent developments in endoscopic ultrasound-guided diagnosis and therapy of pancreatic cystic neoplasms

• Kirtane T
• Bhutani MS

• KMID: 2376913
• DOI: http://doi.org/10.18528/gii.170006

Abstract

This review highlights new developments in the field of endoscopic ultrasound (EUS)-guided diagnosis and therapy of pancreatic cystic neoplasms. Studies pertinent to pancreatic cyst diagnosis by morphology, namely diagnostic accuracies of various criteria such as pancreatic cyst size, pancreatic duct size, mural nodules and use of EUS contrast agent are discussed. Tissue acquisition during EUS using a novel brush for cytology as well as microforceps is explored further. The role of multiple emerging molecular markers such as CEA, BRAF, KRAS, and GNAS, to name a few, is covered in detail. Recent developments relating to the utility of micro-RNAs in the analysis of cyst fluid is explored. Needle based confocal laser endomicroscopy for pancreatic cyst imaging is a recent development, and findings from recent trials are discussed. Furthermore, recent data regarding the role of ablative therapies using alcohol, paclitaxel and radiofrequency ablation of cyst is covered. Also, given the multiplicity of guidelines regarding management of pancreatic cystic neoplasms, we discuss the merits and shortcoming of these guidelines.

Keyword

Biomarkers; Catheter ablation; Endoscopic ultrasound-guided fine needle aspiration; Pancreatic cyst; Pancreatic neoplasms

MeSH Terms

Biomarkers
Catheter Ablation
Cyst Fluid
Diagnosis*
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Needles
Paclitaxel
Pancreatic Cyst*
Pancreatic Ducts
Pancreatic Neoplasms
Ultrasonography
Biomarkers
Paclitaxel