Kras mutation analysis of fine needle aspirate under EUS guidance facilitates risk stratification of patients with pancreatic mass.

作者: Fauze Maluf-Filho , Atul Kumar , René Gerhardt , Márcia Kubrusly , Paulo Sakai

DOI: 10.1097/MCG.0B013E31805905E9

关键词:

摘要: Objectives The accuracy of endoscopic ultrasound-fine needle aspiration cytology (EUS-FNAC) for the diagnosis pancreatic cancer is suboptimal. Mutational activation kras oncogene almost universally present in tissue. We, therefore, investigated if analysis mutant gene EUS-FNAC aspirates supplements cytopathology adenocarcinoma (PAC). Methods specimens obtained from 74 patients with masses were analyzed presence mutation on codon 12 using polymerase chain reaction-restriction fragment length polymorphism and MvaI restriction enzyme. Definitive was based surgical pathology or long-term follow-up (median 27.8 mo); 57 had PAC, 11 patient's chronic pancreatitis, 9 nonfunctioning neuroendocrine tumors. Results Analysis addition to allowed detection PAC 4 additional as compared alone. Cytopathology negative 17 whom 6 (35%) PAC. respective sensitivity (90.9% vs. 82.5%), specificity (47.6% 97.9%), positive predictive value (89.5% 83.8%), (98.1% 94.1%), (89.2% 58.8%) plus versus numerically superior but did not reach statistical significance. Conclusions conventional even without a cytopathologist attendance only 3 passes. Among cytopathology, represents while absence increases possibility benign lesion.

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