Diagnostic yield of liquid‐based cytology in serial pancreatic juice aspiration cytological examination

Kitagawa, Koh; Mitoro, Akira; Tomooka, Fumimasa; Asada, Shohei; Fujinaga, Yukihisa; Nishimura, Norihisa; Kaji, Kosuke; Kawaratani, Hideto; Akahane, Takemi; Ozutsumi, Takahiro; Kaneko, Miki; Fujimoto, Yuki; Tsuji, Yuki; Enomoto, Masahide; Takeda, Soichi; Murata, Kōji; Kubo, Takahiro; Iwai, Satoshi; Koizumi, Aritoshi; Shibamoto, Akihiko; Suzuki, Junya; Tanaka, Mitsuro; Matsuda, Takuya; Yorioka, Nobuyuki; Masuda, Hiroyuki; Takami, Masayoshi; Yoshiji, Hitoshi

doi:10.1002/deo2.177

Cited by 3 publications

(3 citation statements)

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“… 113 The method is initiated via ERCP, whereby an endoscopically placed nasopancreatic drainage allows for serial measurements of pancreatic juice for cytology, or ‘liquid biopsy’. 114 Of note, the method carries the risk of post-ERCP pancreatitis.…”

Section: Further Developments and Novel Technologymentioning

confidence: 99%

“…In this setting, some investigators have used a technique called serial pancreatic juice aspiration cytologic examination (SPACE) for the diagnosis. [111][112][113][114] The approach is not universally available, and early experience comes mainly from Japan, but may represent a useful diagnostic method in select cases for early-stage pancreatic cancers, such as carcinoma in situ that are difficult to diagnose by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). 113 The method is initiated via ERCP, whereby an endoscopically placed nasopancreatic drainage allows for serial measurements of pancreatic juice for cytology, or 'liquid biopsy'.…”

Section: Pancreatic Juice and Cyst Fluidsmentioning

confidence: 99%

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Early Diagnosis of Pancreatic Cancer: Clinical Premonitions, Timely Precursor Detection and Increased Curative-Intent Surgery

et al. 2023

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Background The overall poor prognosis in pancreatic cancer is related to late clinical detection. Early diagnosis remains a considerable challenge in pancreatic cancer. Unfortunately, the onset of clinical symptoms in patients usually indicate advanced disease or presence of metastasis. Analysis and Results Currently, there are no designated diagnostic or screening tests for pancreatic cancer in clinical use. Thus, identifying risk groups, preclinical risk factors or surveillance strategies to facilitate early detection is a target for ongoing research. Hereditary genetic syndromes are a obvious, but small group at risk, and warrants close surveillance as suggested by society guidelines. Screening for pancreatic cancer in asymptomatic individuals is currently associated with the risk of false positive tests and, thus, risk of harms that outweigh benefits. The promise of cancer biomarkers and use of ‘omics’ technology (genomic, transcriptomics, metabolomics etc.) has yet to see a clinical breakthrough. Several proposed biomarker studies for early cancer detection lack external validation or, when externally validated, have shown considerably lower accuracy than in the original data. Biopsies or tissues are often taken at the time of diagnosis in research studies, hence invalidating the value of a time-dependent lag of the biomarker to detect a pre-clinical, asymptomatic yet operable cancer. New technologies will be essential for early diagnosis, with emerging data from image-based radiomics approaches, artificial intelligence and machine learning suggesting avenues for improved detection. Conclusions Early detection may come from analytics of various body fluids (eg ‘liquid biopsies’ from blood or urine). In this review we present some the technological platforms that are explored for their ability to detect pancreatic cancer, some of which may eventually change the prospects and outcomes of patients with pancreatic cancer.

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Section: Further Developments and Novel Technologymentioning

confidence: 99%

Section: Pancreatic Juice and Cyst Fluidsmentioning

confidence: 99%

Early Diagnosis of Pancreatic Cancer: Clinical Premonitions, Timely Precursor Detection and Increased Curative-Intent Surgery

et al. 2023

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“…They also reported that SPACE is particularly useful for diagnosing intraepithelial carcinomas that cannot be delineated using EUS. Since then, there have been increasing reports on diagnosing intraepithelial pancreatic cancer using SPACE, mainly in Japan [ 85 – 88 ].…”

Section: A Diagnostic Approach For Early-stage Pdacmentioning

confidence: 99%

Current status of molecular diagnostic approaches using liquid biopsy

et al. 2023

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Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive and lethal cancers, and developing an efficient and reliable approach for its early-stage diagnosis is urgently needed. Precancerous lesions of PDAC, such as pancreatic intraepithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasms (IPMN), arise through multiple steps of driver gene alterations in KRAS, TP53, CDKN2A, SMAD4, or GNAS. Hallmark mutations play a role in tumor initiation and progression, and their detection in bodily fluids is crucial for diagnosis. Recently, liquid biopsy has gained attention as an approach to complement pathological diagnosis, and in addition to mutation signatures in cell-free DNA, cell-free RNA, and extracellular vesicles have been investigated as potential diagnostic and prognostic markers. Integrating such molecular information to revise the diagnostic criteria for pancreatic cancer can enable a better understanding of the pathogenesis underlying inter-patient heterogeneity, such as sensitivity to chemotherapy and disease outcomes. This review discusses the current diagnostic approaches and clinical applications of genetic analysis in pancreatic cancer and diagnostic attempts by liquid biopsy and molecular analyses using pancreatic juice, duodenal fluid, and blood samples. Emerging knowledge in the rapidly advancing liquid biopsy field is promising for molecular profiling and diagnosing pancreatic diseases with significant diversity.

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Advances in diagnostic liquid‐based cytology

Abe,

Kawahara,

Akiba

et al. 2024

Cytopathology

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Liquid‐based cytology (LBC) has changed the landscape of gynaecological cytology. A growing demand exists for LBC in diagnostic cytology, particularly for ancillary testing, such as immunocytochemistry and molecular testing. Ancillary testing solely based on conventional preparation (CP) methods remains challenging. Recently, the increased demand for specialist testing and minimally invasive techniques, such as endoscopic ultrasonography fine‐needle aspiration, to obtain cellular samples has led to an increasing demand for ancillary testing on cytology LBC supernatant, slides and cell block (CB). This facilitates the diagnosis and prognosis in cytology samples enabling personalized treatment. An understanding of the history and future prospects of LBC is crucial for its application in routine diagnostics by cytopathologists and cytotechnologists. In this review, we initiated an internet search using the keyword ‘liquid‐based cytology’, and we conducted a literature review to discuss the usefulness of combined diagnosis of LBC and CP, immunocytochemistry and molecular testing and assessed the quality of nucleic acids in diagnostic LBC. High‐quality and cell‐rich diagnostic LBC surpassed the CP method alone in terms of reliability and versatility of ancillary testing in cytological diagnosis. Conclusively, diagnostic LBC lends itself to various new technologies and is expected to continue evolving with innovations in the future.

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Diagnostic yield of liquid‐based cytology in serial pancreatic juice aspiration cytological examination

Cited by 3 publications

References 31 publications

Early Diagnosis of Pancreatic Cancer: Clinical Premonitions, Timely Precursor Detection and Increased Curative-Intent Surgery

Early Diagnosis of Pancreatic Cancer: Clinical Premonitions, Timely Precursor Detection and Increased Curative-Intent Surgery

Current status of molecular diagnostic approaches using liquid biopsy

Advances in diagnostic liquid‐based cytology

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