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Background . Researchers have evaluated various molecular tests for improving the differential diagnosis of cystic lesions of the pancreas.  Methods . Six electronic databases were searched for articles on molecular tests for the diagnosis of pancreatic cysts. Measures of accuracy were extracted from selected articles and pooled by the random-effects model. Summary receiver operating characteristic curves were used to analyze the overall accuracy of the molecular tests. Pooled sensitivity and specificity values [95% confidence intervals] are reported.  Results . The systematic review included eight studies of 428 patients in total. We determined the sensitivities and specificities of tests for  KRAS  mutations (0.47 [0.39–0.54], 0.98 [0.93–0.99]) and loss of heterozygosity (0.63 [0.54–0.71], 0.76 [0.63–0.87]) for distinguishing mucinous from nonmucinous cysts, as well as the sensitivities and specificities of tests for  KRAS  mutations (0.59 [0.46–0.71], 0.78 [0.71–0.85]) and loss of heterozygosity (0.89 [0.78–0.96], 0.69 [0.60–0.76]) for differentiating malignant from benign cysts.  Conclusion . Tests of  KRAS  mutations could confirm but not exclude a diagnosis of a mucinous or malignant pancreatic cyst.

Molecular Analyses of Aspirated Cystic Fluid for the Differential Diagnosis of Cystic Lesions of the Pancreas: A Systematic Review and Meta-Analysis