Mayo Clinic researchers have found that a panel of methylated DNA markers in pancreatic cyst fluid can accurately detect advanced precancerous lesions and early cancer in pancreatic cysts. Hypermethylation is a process thought to play a role in silencing of tumor suppressor genes, which are involved in controlling cell growth and division. Uncontrolled cell growth and division can lead to cancer development.

"Pancreatic cysts are common and are often detected incidentally," says Shounak Majumder, MBBS, a Mayo Clinic gastroenterologist. "The majority of these cysts are benign. However, a subset is premalignant, and the risk of pancreatic cancer in these patients is significantly higher than the general population."

Dr. Majumder says current methods to detect early cancer or advanced precancer in pancreatic cysts, such as radiological imaging, often lack diagnostic accuracy, which can result in unnecessary surgeries.

Dr. Majumder presented the results of a multicenter study of a panel of new DNA methylation markers assayed from the pancreatic cyst of 134 patients at the Digestive Disease Week 2017 meeting.

"The detection accuracy of this panel of markers was significantly higher than currently available markers," Dr. Majumder says. "These cyst fluid biomarkers can potentially change the paradigm of clinical practice in patients with pancreatic cysts by accurately identifying cysts that harbor early cancer or advanced precancer that would benefit the most from surgery. This would lead to improved patient outcomes, both in terms of being able to detect cancer early and also avoiding potentially morbid surgical intervention in those who do not need it."

Based on the results of this study, Dr. Majumder, along with David Ahlquist, MD, Mark Topazian, MD, and Gloria Petersen, PhD – all Mayo Clinic gastroenterologists – will lead a prospective study funded by the National Institutes of Health to validate these new cyst fluid markers. Dr. Majumder says additional research is also underway to identify methylated DNA markers in pancreatic juice, plasma and stool for early detection of pancreatic cancer.