Evidence map›Paper›PMID 41388172›Full record

ArticleAnnals of surgical oncology2026

PancreaSeq Genomic Classifier (PancreaSeq GC) Improves Pancreatic Cyst Classification and Detection of Advanced Neoplasia: A Multi-institutional Validation Study.

Aatur D Singhi, Abigail I Wald, Katelyn Smith, Lynn Wolkenstein, Robert D Bubar, Ricardo Diaz-Aragon, Maria Grupillo, Danielle Guckin, Yi-Tak Lai, Randall E Brand and 49 more

Abstract readMulticenter StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

59 authors.

Aatur D SinghiDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. singhiad@upmc.edu.ORCID http://orcid.org/0000-0003-3930-7096
Abigail I WaldDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Katelyn SmithDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Lynn WolkensteinDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Robert D BubarDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Ricardo Diaz-AragonDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Maria GrupilloDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Danielle GuckinDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Yi-Tak LaiDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Randall E BrandDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Kevin McGrathDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Walter G ParkDepartment of Medicine, Stanford University, Stanford, CA, USA.
Patrick R PfauDepartment of Medicine, University of Wisconsin, Madison, WI, USA.
Patricio M PolancoDepartment of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Nisa KubiliunDepartment of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
John DeWittDepartment of Gastroenterology and Hepatology, Indiana University Health Medical Center, Indianapolis, IN, USA.
Jeffrey J EaslerDepartment of Gastroenterology and Hepatology, Indiana University Health Medical Center, Indianapolis, IN, USA.
Aamir DamPiedmont Advanced Gastroenterology Atlanta, Atlanta, GA, USA.
Shaffer R MokDepartment of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA.
Michael B WallaceDepartment of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA.
Brian A BooneDepartment of Surgery, West Virginia University Health Sciences Center, Morgantown, WV, USA.
Wallis MarshDepartment of Surgery, West Virginia University Health Sciences Center, Morgantown, WV, USA.
Shyam ThakkarDepartment of Medicine, Section of Gastroenterology & Hepatology, West Virginia University Health Sciences Center, Morgantown, WV, USA.
Kimberly J FairleyDepartment of Medicine, Section of Gastroenterology & Hepatology, West Virginia University Health Sciences Center, Morgantown, WV, USA.
Elham AfghaniThe Sol Goldman Pancreatic Cancer Research Center, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Yasser BhatDepartment of Gastroenterology, Palo Alto Medical Foundation (PAMF), Mountain View, CA, USA.
Sanjay RamrakhianiDepartment of Gastroenterology, Palo Alto Medical Foundation (PAMF), Mountain View, CA, USA.
John NasrDepartment of Medicine, Wheeling Hospital, West Virginia University Health Sciences Center, Morgantown, WV, USA.
Nikhil R ThiruvengadamDepartment of Medicine, Division of Gastroenterology and Hepatology, Loma Linda University Medical Center, Loma Linda, CA, USA.
Asif KhalidDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Kenneth FasanellaDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Jennifer ChennatDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Rohit DasDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Harkirat SinghDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Adam SlivkaDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Charles GabbertDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Tarek SawasDepartment of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Thomas TiellemanDepartment of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Hendrikus Dutch VanderveldtDepartment of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Anna TavakkoliDepartment of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Lynette M SmithDepartment of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
Anju H SinghiDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Sara A SinghiDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Stephanie RomutisDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Sultan MahmoodDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Amy E HosmerDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Julia McNabb-BaltarDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Anne Marie LennonDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Ralph H HrubanThe Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Nuha ShakerDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Alessandro PanicciaDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Amer ZureikatDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Kenneth K LeeDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Melanie OngchinDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Herbert ZehDepartment of Clinical Sciences, Surgery, University of Texas Southwestern, Dallas, TX, USA.
Rebecca MinterDepartment of Surgery, University of Wisconsin, Madison, WI, USA.
C Max SchmidtDepartment of Surgery, Indiana University Health Medical Center, Indianapolis, IN, USA.
Jin HeThe Sol Goldman Pancreatic Cancer Research Center, Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Marina N NikiforovaDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. nikiforovamn@upmc.edu.

Funding

Division of Cancer Prevention, National Cancer Institute R37CA263622Division of Cancer Prevention, National Cancer Institute U01CA200466Division of Cancer Prevention, National Cancer Institute U01CA282272DOD Peer Reviewed Cancer Research Program W81XWH-21-1-0709
6 · The paper itself

Abstract

backgroundThe preoperative classification of pancreatic cysts and detection of advanced neoplasia (high-grade dysplasia/pancreatic ductal adenocarcinoma [PDAC]) represents a significant diagnostic challenge. A prospective, multi-institutional study found that DNA-based testing (PancreaSeq) of pancreatic cyst fluid (PCF) improved the assessment of pancreatic cysts. Notable imitations to PancreaSeq necessitated the development of a DNA/RNA-based panel called PancreaSeq Genomic Classifier (GC). We validated PancreaSeq GC on a prospective patient cohort. PATIENTS AND

methodsPancreaSeq GC was blindly tested on a prospective cohort of 241 patients with diagnostic follow-up. The performance of PancreaSeq GC in this cohort, which included 186 mucinous cysts (97 with advanced neoplasia), was benchmarked against traditional diagnostics and its DNA-only predecessor, PancreaSeq.

resultsPancreaSeq GC achieved 94.6% sensitivity and 96.4% specificity (area under the curve [AUC] of 0.955) for mucinous cysts. In comparison, increased fluid viscosity, elevated carcinoembryonic antigen (CEA), and PancreaSeq testing had lower sensitivities (71.4-88.2%) and lower AUC (0.824-0.941); however, PancreaSeq specificity was 100%. McNemar's test demonstrated higher sensitivity of PancreaSeq GC versus PancreaSeq for mucinous cysts (p < 0.001). For advanced neoplasia, PancreaSeq GC had 86.6% sensitivity and 97.9% specificity (AUC of 0.923), with McNemar's test confirming improved sensitivity over PancreaSeq (p = 0.031). Worrisome features, malignant cytopathology, and high-risk stigmata had lower sensitivities (44.3-84.5%) and lower AUC (0.604-0.892), while PancreaSeq had identical specificity to PancreaSeq GC. PancreaSeq GC had high accuracy in classifying intraductal oncocytic papillary neoplasms (IOPNs), intraductal tubulopapillary neoplasms (ITPNs), and cystic pancreatic neuroendocrine tumors (cPanNETs), with 97.1-100% sensitivity and 100% specificity.

conclusionsThis validation study demonstrates statistically significant improvements in PancreaSeq GC for mucinous cysts and advanced neoplasia, establishing it as a clinically valuable tool for the preoperative evaluation of pancreatic cysts.

Indexed as

Biomarkers, TumorCarcinoma, Pancreatic DuctalGenomicsPancreatic CystPancreatic NeoplasmsAdultAgedCyst FluidFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisProspective StudiesBiomarkers, TumorIntraductal oncocytic papillary neoplasmIntraductal papillary mucinous neoplasmMucinous cystic neoplasmPancreatic ductal adenocarcinomaPancreatic neuroendocrine tumorPseudocystSerous cystadenoma

Identifiers

PMID41388172
PMCPMC12982251

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