What is the current knowledge on cyst fluid biomarkers? Do they play any role in practice?
Paul Moayyedi: In practice – none. This is the holy grail which is still being searched for: to find a genetic mutation that can predict malignancy. Whilst there have been many promises in this field, it has been disappointing up to now, I think it is fair to say.
Most will look for carcinoembryonic antigen (CEA) because that can differentiate between a mucinous cyst and a serous cyst, which can be at least somewhat helpful, but it does not tell you whether that mucinous cyst has any malignant potential. It does not differentiate between malignancy and benign cysts.