We read with interest the paper by Singhi et al.1 The authors prospectively assessed using targeted next-generation sequencing (NGS) 626 pancreatic cyst fluid (PCF) samples from 595 patients. They found that compared with Sanger sequencing, cytology and CEA, preoperative NGS for KRAS/GNAS mutations is highly sensitive for intraductal papillary mucinous neoplasms (IPMNs) and specific for mucinous pancreatic cysts (PCs).
Moreover, alterations in TP53/PIK3/PTEN are significantly associated with advanced neoplasia facilitating decision-making for the management of these lesions.
Despite the evidence that NGS outperforms complementary techniques, we remain puzzled by several features related to the methodology used.
The Results section of the paper shows that the majority of the cases (93%) were satisfactory for molecular testing.
On the contrary, the amount of cyst fluid was insufficient for CEA analysis in 28% of cases, and 60% of specimens were either less than optimal (47%) or unsatisfactory (13%) for cytopathological diagnosis. The proposed primary reason for specimen...
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