The use of protein-based biomarkers for the diagnosis of cystic tumors of the pancreas

Abstract

Proteomics is a powerful method used to identify, characterize, and quantify proteins within biologic samples. Pancreatic cystic neoplasms are a common clinical entity and represent a diagnostic and management challenge due to difficulties in accurately diagnosing cystic lesions with malignant potential and assessing the risk of malignant degeneration. Currently, cytology and other biomarkers in cyst fluid have had limited success in accurately distinguishing both the type of cystic neoplasm and the presence of malignancy. Emerging data suggests that the use of protein-based biomarkers may have greater utility in helping clinicians correctly diagnose the type of cyst and to identify which cystic neoplasms are malignant. Several candidate proteins have been identified within pancreatic cystic neoplasms as potential biomarkers. Future studies will be needed to validate these findings and move these biomarkers into the clinical setting.

Figure 1

These images highlight the limitations of cross-sectional imaging and endoscopic ultrasound (EUS) in differentiating cyst types. By CT ((a)+(c)) and by EUS ((b)+(d)), the two cysts look very similar. The cyst in (a) and (b) was a macrocystic serous cystadenoma and the cyst in (c) and (d) was a mucinous cystadenoma. The histology of both was confirmed by surgical resection.