Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of pancreatic cysts by combined cytopathology and cystic content analysis

Table 2 Criteria for integrated molecular pathology diagnostic categories

Diagnostic category	Molecular criteria1	Co-existing concerning clinical features2
Benign	DNA lacks molecular criteria	Not considered for this diagnosis
Statistically indolent	DNA meets 1 molecular criterion	None
SHR	DNA meets 1 molecular criterion	1 or more
Aggressive	DNA meets at least 2 molecular criteria	Not considered for this diagnosis

¹Four molecular criteria that have been independently correlated with pancreatic malignancy or high-grade dysplasia are used to make an integrated molecular pathology diagnosis: (1) a single high-clonality mutation; (2) elevated level of high-quality DNA; (3) multiple low-clonality mutations; and (4) a single low-clonality oncogene mutation;

²Include any of the following: cyst size  >  3  cm, growth rate  >  3  mm/year, duct dilation  >  1  cm, carcinoembryonic antigen level  >  1000  ng/mL, cytologic evidence of high-grade dysplasia. (Table 2 from Al-Haddad et al[75] 2015 was permitted by publisher). SHR: Statistically higher risk.