*Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
†Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
‡The Sol Goldman Pancreatic Cancer Research Center, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA
§Department of Medicine, Stanford University, Stanford, CA, USA
∥Department of Medicine, University of Wisconsin, Madison, WI, USA
¶Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
#Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
**Department of Gastroenterology and Hepatology, Indiana University Health Medical Center, Indianapolis, IN, USA
††Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA
‡‡Department of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
§§Sheikh Shakhbout Medical City, Abu Dhabi, UAE
∥∥Department of Surgery, West Virginia University Health Sciences Center, Morgantown, WV, USA
¶¶Department of Medicine, Section of Gastroenterology & Hepatology, West Virginia University Health Sciences Center, Morgantown, WV, USA
##Department of Gastroenterology, Palo Alto Medical Foundation (PAMF), Mountain View, CA, USA
***Department of Medicine, Wheeling Hospital, West Virginia University Health Sciences Center, Morgantown, WV, USA
†††Department of Medicine, Division of Gastroenterology and Hepatology, Loma Linda University Medical Center, Loma Linda, CA, USA
‡‡‡Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
§§§The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
∥∥∥Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
¶¶¶Department of Clinical Sciences, Surgery, University of Texas Southwestern, Dallas, TX, USA
###Department of Surgery, University of Wisconsin, Madison, WI, USA
****The Sol Goldman Pancreatic Cancer Research Center, Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
Key Abbreviations: AF, allele frequency; AUC, area under the ROC curve; CEA, carcinoembryonic antigen; EUS, endoscopic ultrasound; IOPN, intraductal oncocytic papillary neoplasm; IPMN, intraductal papillary mucinous neoplasm; LOH, loss of heterozygosity; MAPK, mitogen-activated protein kinase; MCN, mucinous cystic neoplasm; NGS, next-generation sequencing; NPV, negative predictive value; PanNET, pancreatic neuroendocrine tumor; PC, pancreatic cyst; PCF, pancreatic cyst fluid; PPV, positive predictive value; ROC, receiver operating characteristic; SCA, serous cystadenoma; SPN, solid-pseudopapillary neoplasm.
Author Contributions: Study Concept and Design: MNN, AIW, ADS. Acquisition of Clinical and Pathological Data: MNN, AIW, DMS, MAM, MG, YTL, REB, AMOL, KM, WGP, PRP, PMP, NK, JD, JJE, AD, SRM, MBW, VK, BAB, WM, ST, KJF, EA, YB, SR, JN, WS, AK, KF, JC, RD, HS, SS, AS, CG, TS, TT, HDV, AT, LMS, KS, PDB, RHH, AP, AZ, KKL, MO, HZ, RM, JH, YEN, ADS. Analysis and Interpretation of Data: MNN, AIW, DMS, LMS, YEN, ADS. Drafting of the Manuscript: MNN, AIW, DMS, YEN, ADS.
Funding Contributions: This study was supported in part by the Department of Defense (W81XWH-21-1-0709), National Cancer Institute (NIH/NCI 1U01CA200466 and 5R37CA263622), the Pittsburgh Liver Research Center at the University of Pittsburgh (NIH/NIDDK P30DK120531), the University of Pittsburgh Medical Center, and the National Pancreas Foundation, Western Pennsylvania Chapter.
Disclosure/conflict of interest: Dr. Singhi has received an honorarium from Foundation Medicine, Inc. Dr. Nikiforova and Dr Nikiforov own intellectual property related to the PancreaSeq technology and receive royalties from University of Pittsburgh. Dr. Hruban has the potential to receive royalty payments from Thrive Earlier Detection for the GNAS invention in an arrangement reviewed and approved by the Johns Hopkins University in accordance with its conflict-of-interest policies. The remaining authors have disclosed that they have no financial interests, arrangements, affiliations, or commercial interests with the manufacturers of any products discussed in this article or their competitors.
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