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Gastroenterology Research and Practice
Volume 2016, Article ID 3546085, 8 pages
Research Article

Molecular Analyses of Aspirated Cystic Fluid for the Differential Diagnosis of Cystic Lesions of the Pancreas: A Systematic Review and Meta-Analysis

Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China

Received 15 July 2015; Revised 26 September 2015; Accepted 28 September 2015

Academic Editor: Oliver Strobel

Copyright © 2016 Xiaorong Guo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Researchers have evaluated various molecular tests for improving the differential diagnosis of cystic lesions of the pancreas. Methods. Six electronic databases were searched for articles on molecular tests for the diagnosis of pancreatic cysts. Measures of accuracy were extracted from selected articles and pooled by the random-effects model. Summary receiver operating characteristic curves were used to analyze the overall accuracy of the molecular tests. Pooled sensitivity and specificity values [95% confidence intervals] are reported. Results. The systematic review included eight studies of 428 patients in total. We determined the sensitivities and specificities of tests for KRAS mutations (0.47 [0.39–0.54], 0.98 [0.93–0.99]) and loss of heterozygosity (0.63 [0.54–0.71], 0.76 [0.63–0.87]) for distinguishing mucinous from nonmucinous cysts, as well as the sensitivities and specificities of tests for KRAS mutations (0.59 [0.46–0.71], 0.78 [0.71–0.85]) and loss of heterozygosity (0.89 [0.78–0.96], 0.69 [0.60–0.76]) for differentiating malignant from benign cysts. Conclusion. Tests of KRAS mutations could confirm but not exclude a diagnosis of a mucinous or malignant pancreatic cyst.