Detection of KRAS Gene Mutations in Endoscopic Ultrasound-Guided Fine-Needle Aspiration Biopsy for Improving Pancreatic Cancer Diagnosis

Abstract

Our method for the detection of KRAS gene mutations may be useful to supplement histo/cytopathologic evaluations for pancreatic cancer, and is superior to serum CA19-9 in EUS-FNAB histo/cytopathology-indeterminate patients. Results warrant further verification in other patient populations.

Chronic Pancreatitis and Pancreatic Cancer

“…Combined normal serum CA19-9 and absence of circulating KRAS2 mutations may significantly increase the differential diagnosis efficacy between CP and PC [56]. Our study also showed that the detection of KRAS gene mutations (codons 12 and 13) in samples of endoscopic ultrasound-guided fine needle aspiration biopsy was feasible for the diagnosis of PC [57]. …”

Oncogenic KRAS Targets MUC16/CA125 in Pancreatic Ductal Adenocarcinoma

“…For example, endoscopic ultrasound-guided fine-needle aspiration biopsy is a useful tool in the diagnosis of pancreatic masses. Combination of genetic analysis of these samples with serum levels of tumor markers like CA19-9 could increase the sensitivity and specificity of diagnosis (44). However, no similar result has been reported by using Kras mutation status by conjugation with CA125 levels in improving sensitivity and specificity of diagnosis in pancreatic cancer, and this warrants further investigations.…”

Nanofluidic Digital PCR for KRAS Mutation Detection and Quantification in Gastrointestinal Cancer

“…Of note is that KRAS gene mutations appear to occur in a substantial proportion of intraductal lesions [pancreatic intraepithelial neoplasia (PanIN) 1a, 1b, 2, and 3 lesions (38 )], in 53% of adenomatous hyperplasias, and in 36% of papillary hyperplasias (39 )-all of which are precancerous conditions for pancreatic cancer. In other cases, however, this heterogeneity occurs within the tumor, suggesting the presence of a polyclonal growth even in advanced stages of the disease (15 ).…”

“…With the advent of ther-apies that target the epidermal growth factor receptor in patients with metastatic colorectal cancer, KRAS has emerged as a major predictive marker, because tumors containing KRAS mutations are believed to be unresponsive to cetuximab or panitumumab treatment (9 -14 ). Detection of KRAS mutations has also been clinically useful for diagnosing pancreatic tumors via analysis of tumor biopsies, pancreatic juice, serum, and stool DNA (6,15,16 ). In this setting, the lack of diagnostic specificity has precluded more-widespread use.…”