Next-generation sequencing of pancreatic cyst wall specimens obtained using micro-forceps for improving diagnostic accuracy

Background and study aims: Pancreatic cysts are common incidental findings, with an estimated prevalence of 13-15% in imaging done for other reasons. Diagnosis often relies on collection cyst fluid, but tissue sampling using micro-forceps may allow a more reliable diagnosis higher yield DNA next-generation sequencing (NGS). The primary aim was to assess the performance NGS identifying mucinous cyst. secondary aims were between fluid wall tissue, complication rate conventional investigations. Patients methods: 24 patients referred endoscopic ultrasound recruited. Biopsies taken AmpliSeq Cancer Hotspot panel used NGS, PCR assay targeting several hotspots within 50 genes, including GNAS, KRAS VHL. Results: concentration extracted from samples significantly than 9/24 available matched samples. sensitivity, specificity diagnostic accuracy diagnosing 93%, 50% 84%, standard care -66.6%, 63.1% 100%, 89.4% respectively. Cyst biopsy able diagnose 19/24 (4 high risk, 7 intraductal papillary neoplasm, 4 origin benign). Conclusions: data correlates well histology aid risk stratification pancreatic cysts. performs inadequate 5/24 patients.