Parameter | Sensitivity (95% CI) | Specificity (95% CI) |
IPMNs | ||
KRAS and/or GNAS mutations | 100% (0.92 to 1.00) | 96% (0.84 to 0.99) |
Presence of multiple cysts | 54% (0.40 to 0.67) | 72% (0.56 to 0.84) |
Increased fluid viscosity | 82% (0.69 to 0.91) | 80% (0.66 to 0.90) |
Elevated CEA* | 57% (0.40 to 0.73) | 70% (0.53 to 0.83) |
IPMNs with advanced neoplasia | ||
TP53, PIK3CA and/or PTEN alterations | 88% (0.62 to 0.98) | 95% (0.88 to 0.98) |
KRAS and/or GNAS mutations with TP53, PIK3CA and/or PTEN alterations | 88% (0.62 to 0.98) | 97% (0.89 to 0.99) |
GNAS MAF >55% or TP53/PIK3CA/PTEN MAFs at least equal to KRAS/GNAS MAFs | 100% (0.77 to 1.00) | 100% (0.95 to 1.00) |
Main pancreatic duct dilatation | 47% (0.24 to 0.71) | 74% (0.63 to 0.83) |
Presence of a mural nodule | 35% (0.15 to 0.61) | 94% (0.86 to 0.98) |
Malignant cytopathology† | 35% (0.15 to 0.61) | 97% (0.91 to 1.00) |
IPMNs and MCNs | ||
KRAS and/or GNAS mutations | 89% (0.79 to 0.95) | 100% (0.88 to 1.00) |
Increased fluid viscosity | 77% (0.65 to 0.86) | 89% (0.73 to 0.96) |
Elevated CEA* | 57% (0.42 to 0.71) | 80% (0.61 to 0.92) |
IPMNs and MCNs with advanced neoplasia | ||
TP53, PIK3CA and/or PTEN alterations | 79% (0.54 to 0.93) | 95% (0.88 to 0.98) |
KRAS and/or GNAS mutations with TP53, PIK3CA and/or PTEN alterations | 79% (0.54 to 0.93) | 96% (0.89 to 0.99) |
GNAS MAF >55% or TP53/PIK3CA/PTEN MAFs at least equal to KRAS/GNAS MAFs | 89% (0.66 to 0.98) | 100% (0.95 to 1.00) |
Main pancreatic duct dilatation | 42% (0.21 to 0.66) | 74% (0.63 to 0.82) |
Presence of a mural nodule | 32% (0.14 to 0.57) | 94% (0.86 to 0.98) |
Malignant cytopathology† | 32% (0.13 to 0.57) | 98% (0.91 to 1.00) |
*On the basis of cases in which sufficient fluid was available for CEA testing.
†Malignant cytopathology was defined as at least suspicious for adenocarcinoma.
CEA, carcinoembryonic antigen; MAF, mutant allele frequency; PC, pancreatic cyst.