Somatic molecular analysis augments cytologic evaluation of pancreatic cyst fluids as a diagnostic tool.
作者： Ali Sakhdari , Parnian Ahmadi Moghaddam , Chi Young Ok , Otto Walter , Keith Tomaszewicz
DOI: 10.18632/ONCOTARGET.26999
关键词: GNAS complex locus 、 PTEN 、 CDKN2A 、 KRAS 、 Cytology 、 Grading (tumors) 、 Pathology 、 Allele frequency 、 Adenocarcinoma 、 Medicine
摘要: Objective: Better tools are needed for early diagnosis and classification of pancreatic cystic lesions (PCL) to trigger intervention before neoplastic precursor progress adenocarcinoma. We evaluated the capacity molecular analysis improve accuracy cytologic PCL with an emphasis on non-diagnostic/negative specimens. Design: In a span 7 years, at tertiary care hospital, 318 endoscopic ultrasound-guided fine needle aspirations (EUS-FNA) were by examination analysis. Mucinous identified based clinical algorithm 46 surgical resections used verify this approach. The mutation allele frequency (MAF) commonly altered genes (BRAF, CDKN2A, CTNNB1, GNAS, RAS, PIK3CA, PTEN, SMAD4, TP53 VHL) was their ability identify grade mucinous PCL. Results: Cytology showed diagnostic sensitivity 43.5% due in part impact non-diagnostic (28.8%) negative (50.5%) Incorporating algorithmic approach or markedly increased evaluation. Detection 93.3% detection KRAS and/or GNAS gene mutations (p = 0.0001). Additional provided marginal improvement but associated cyst type (e.g. SMAD4). cohort, proposed comparable (88.9% vs. 100%). Conclusions: somatic evaluation EUS-FNA increases detection, grading This has potential patient management.
sci-hub.st 参考文章(50)
P Capelli, A Tonsi, N Sartori, R Salvia, L Festa, G Butturini, C Biasutti, P Pederzoli, Pancreatic cystic tumors. Minerva Chirurgica. ,vol. 59, pp. 185- 207 ,(2004)
Barbara A. Centeno, Fine Needle Aspiration Biopsy of the Pancreas ,(1998)
Martin Jones, Zongli Zheng, Jessica Wang, Jonathan Dudley, Emily Albanese, Abdurrahman Kadayifci, Dora Dias-Santagata, Long Le, William R. Brugge, Carlos Fernandez-del Castillo, Mari Mino-Kenudson, A. John Iafrate, Martha B. Pitman, Impact of next-generation sequencing on the clinical diagnosis of pancreatic cysts Gastrointestinal Endoscopy. ,vol. 83, pp. 140- 148 ,(2016) , 10.1016/J.GIE.2015.06.047
Simeon Springer, Yuxuan Wang, Marco Dal Molin, David L. Masica, Yuchen Jiao, Isaac Kinde, Amanda Blackford, Siva P. Raman, Christopher L. Wolfgang, Tyler Tomita, Noushin Niknafs, Christopher Douville, Janine Ptak, Lisa Dobbyn, Peter J. Allen, David S. Klimstra, Mark A. Schattner, C. Max Schmidt, Michele Yip-Schneider, Oscar W. Cummings, Randall E. Brand, Herbert J. Zeh, Aatur D. Singhi, Aldo Scarpa, Roberto Salvia, Giuseppe Malleo, Giuseppe Zamboni, Massimo Falconi, Jin-Young Jang, Sun-Whe Kim, Wooil Kwon, Seung-Mo Hong, Ki-Byung Song, Song Cheol Kim, Niall Swan, Jean Murphy, Justin Geoghegan, William Brugge, Carlos Fernandez-Del Castillo, Mari Mino-Kenudson, Richard Schulick, Barish H. Edil, Volkan Adsay, Jorge Paulino, Jeanin van Hooft, Shinichi Yachida, Satoshi Nara, Nobuyoshi Hiraoka, Kenji Yamao, Susuma Hijioka, Schalk van der Merwe, Michael Goggins, Marcia Irene Canto, Nita Ahuja, Kenzo Hirose, Martin Makary, Matthew J. Weiss, John Cameron, Meredith Pittman, James R. Eshleman, Luis A. Diaz, Nickolas Papadopoulos, Kenneth W. Kinzler, Rachel Karchin, Ralph H. Hruban, Bert Vogelstein, Anne Marie Lennon, A Combination of Molecular Markers and Clinical Features Improve the Classification of Pancreatic Cysts Gastroenterology. ,vol. 149, pp. 1501- 1510 ,(2015) , 10.1053/J.GASTRO.2015.07.041
Andrew M. Bellizzi, Edward B. Stelow, Pancreatic cytopathology: a practical approach and review. Archives of Pathology & Laboratory Medicine. ,vol. 133, pp. 388- 404 ,(2009) , 10.1043/1543-2165-133.3.388
LesterJ. Layfield, Hormoz Ehya, ArmandoC. Filie, RalphH. Hruban, Nirag Jhala, Loren Joseph, Philippe Vielh, MarthaB. Pitman, Utilization of ancillary studies in the cytologic diagnosis of biliary and pancreatic lesions: The Papanicolaou Society of Cytopathology Guidelines CytoJournal. ,vol. 11, pp. 4- 4 ,(2014) , 10.4103/1742-6413.133352
Amy G. Zhou, Lloyd M. Hutchinson, Ediz F. Cosar, Urine Cytopathology and Ancillary Methods Surgical Pathology Clinics. ,vol. 7, pp. 77- 88 ,(2014) , 10.1016/J.PATH.2013.10.003
Sevdenur Cizginer, Brian Turner, A. Reyyan Bilge, Cetin Karaca, Martha B. Pitman, William R. Brugge, Cyst Fluid Carcinoembryonic Antigen Is an Accurate Diagnostic Marker of Pancreatic Mucinous Cysts Pancreas. ,vol. 40, pp. 1024- 1028 ,(2011) , 10.1097/MPA.0B013E31821BD62F
M. Sugiyama, Y. Izumisato, N. Abe, T. Masaki, T. Mori, Y. Atomi, Predictive factors for malignancy in intraductal papillary-mucinous tumours of the pancreas. British Journal of Surgery. ,vol. 90, pp. 1244- 1249 ,(2003) , 10.1002/BJS.4265
S. A. Forbes, N. Bindal, S. Bamford, C. Cole, C. Y. Kok, D. Beare, M. Jia, R. Shepherd, K. Leung, A. Menzies, J. W. Teague, P. J. Campbell, M. R. Stratton, P. A. Futreal, COSMIC: mining complete cancer genomes in the Catalogue of Somatic Mutations in Cancer. Nucleic Acids Research. ,vol. 39, pp. 945- 950 ,(2011) , 10.1093/NAR/GKQ929