CDKN2A and lipoid nephrosis: Furthermore, high-grade lesions demonstrate loss of CDKN2A, TP53, and SMAD4.36 Due to the paucity of specific genetic markers for MCN, the preoperative diagnosis is based solely on excluding other differential diagnoses.37 The 5-year survival rates vary from nearly 100% in individuals with low-grade to about 60% in those with high-grade MCNs.