SMAD4 and cyst: However, when comparing fluid molecular testing with microforceps biopsies from the cyst wall, in a meta-analysis of studies testing for at least four genetic mutations, including KRAS, GNAS, VHL and at least one other genetic mutation characteristic of an aggressive neoplasm (PIK3CA, TP53, SMAD4, PTEN, CDKN2A), on 1206 patients, the diagnostic yields for identification of high-risk cysts, mucinous low-risk cysts and benign cysts were found to be higher for EUS-TTNB than for genetic analysis (73% vs. 54%), but the rates of correctly identified types of cyst were the same (73% vs. 71%) [60].