Confocal endomicroscopy and cyst fluid molecular analysis: Comprehensive evaluation of pancreatic cysts

Table 2 Summary of imaging (endoscopic ultrasound-needle-based confocal laser endomicroscopy) and molecular (cyst-fluid) biomarkers characteristic of different types of pancreatic cystic lesions

	IPMN	MCN	SCA	SPN	PC	NEN
Imaging biomarker
nCLE patterns	Finger-like Papillae[17,24]	Epithelial bands (single or multiple)[17]	Fern pattern or superficial vascular network[17,19]	Not well defined	Bright particles against dark background[17]	Trabecular pattern[17]
	Rope ladder or branched type vascularity[49]	Rope ladder or branched type vascularity[49]
Molecular biomarker
Cyst fluid molecular analysis	KRAS, GNAS, RNF43 positive[25,31,34]	KRAS, RNF43 positive, GNAS negative[25,31]	VHL positive[29]	CTNNB1 positive[25]	Negative	Not well characterized
Cysts with advanced neoplasia	TP53, SMAD4, PIK3CA, PTEN, CKDN2A positive[35,38,37]	TP53, SMAD4, PIK3CA, PTEN, CKDN2A positive[31]
	p16, p53 positive[37]

nCLE: Needle-based confocal laser endomicroscopy; IPMN: Intraductal papillary mucinous neoplasm; MCN: Mucinous cystic neoplasm; SCA: Serous cystadenoma; SPN: Solid pseudopapillary neoplasm; PC: Pseudocyst; NEN: Neuroendocrine neoplasm; Advanced neoplasia: Presence of high-grade dysplasia and/or adenocarcinoma.