Preoperative diagnosis of the malignancy for pancreatic cystic neoplasms        FU De-liang. Department of Pancreatic Surgery of Huashan Hospital; Pancreatic Disease Institute; Shanghai Medical College, Fudan University, Shanghai 200040, China
Abstract    Pancreatic cystic neoplasms (PCN) are being increasingly detected due to widespread use of abdominal imaging and improved imaging techniques. The most common types of PCN are serous cystic neoplasms (SCN), mucinous cystic neoplasms (MCN), intraductal papillary mucinous neoplasms (IPMN)and solid pseudopapillary neoplasm(SPN). Diagnosis of malignancy in PCNs cases requires radical pancreatectomy. Clinical， radiological and laboratory characteristics of PCNs may predict underlying malignancy, including male sex, abdominal mass, weight loss, larger tumor size, local invasion, and elevated CA19-9. Recent developments of clinical, radiological, and laboratory modalities used for preoperative diagnosis and differential diagnosis of PCNs are provided this review. Analysis of DNA mutations, microRNA and proteins within pancreatic cyst fluid by EUS-FNA have identified potential biomarkers to aid with the management of patients with pancreatic cystic neoplasms.