Pearls and Pitfalls of Real-Life Molecular Testing on Fine-Needle Aspiration and Core Biopsy in Pancreatic Adenocarcinoma Practice

Molecular testing is feasible and may even be more successful in cytologic smears than in biopsies or resections. High diagnostic yield and rapid processing favor their integration into routine molecular workflows. The superior performance of smears may relate to reduced stromal content and minimal processing delays. Cytologic specimens showed 100% DNA QC success, even when RNA QC failed, supporting their reliability. Although RNA analysis had a modest failure rate, its overall success suggests it can be incorporated into routine testing, particularly as fusion-driven targets gain clinical relevance.