Highlights
The study reveals that mixed-type intraductal papillary mucinous neoplasms (IPMNs) are significantly more likely to harbor high-risk mutations (HRMs) such as TP53, SMAD4, and MTOR compared to branch-duct (BD) IPMNs (31% vs. 9.3%). Cyst fluid next-generation sequencing (NGS) using the PancreaSeq platform demonstrated a remarkable 100% specificity and 90% sensitivity in predicting advanced neoplasia within mixed-type IPMNs. These findings suggest that molecular analysis can effectively ‘upgrade’ or ‘downgrade’ clinical risk, potentially sparing patients from unnecessary surgery while identifying those at highest risk for progression to invasive carcinoma.
