Evaluation of clinical relevance of examining K-ras, p16 and p53 mutations along with allelic losses at 9p and 18q in EUS-guided fine needle aspiration samples of patients with chronic pancreatitis and pancreatic cancer

Salek, Cyril; Benešová, Lucie; Zavoral, Miroslav; Nosek, Vladimír; Kasperova, L; Ryska, Miroslav; Strnad, R; Traboulsi, Eva; Minárik, Marek

doi:10.3748/wjg.v13.i27.3714

Cited by 92 publications

(78 citation statements)

References 34 publications

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“…Two notable differences were observed in comparison to other studies that have included the surgical specimen. First, in contrast to this study, false positive p53 stainings in be nign pancreatic lesions were demonstrated in previous studies at rates ranging from 3% to about 10% [12,13,26,27,[31][32][33] . Indeed, wild-type p53 over-expression can be inducible under certain benign conditions, such as during inflammation in response to TNF-alpha [34] .…”

Section: Discussioncontrasting

confidence: 99%

“…The p53 abnormality is detected in 50% to 90% of pancreatic adenocarcinomas [23][24][25][26][27][28][29][30][31] , and in their precursor, PanIN, the positive stain ing is directly correlated to the grade [17,[29][30][31] . Our findings agree with previous studies on EUS-FNA of pancreas, which showed that the addition of p53 IH or DNA analysis resulted in a modest sensitivity gain [12][13][14] . Two notable differences were observed in comparison to other studies that have included the surgical specimen.…”

Section: Discussionsupporting

confidence: 92%

“…In this study, routine cytology had sensitivity of 41%, which is much lower than previously reported (usual range 70% to 90% [2][3][4][5][6][7][8][9][10][11][12][13][14] ). This was due to higher prevalence of indeterminate cytology at 46%, versus 4% to 26% reported in other studies [2][3][4][5][6][7][8][9][10][11][12][13][14] . The discrepancy is possibly due to instances of differing cytologic criteria having been applied to different patient populations.…”

Section: Discussioncontrasting

confidence: 71%

“…The overall 5-year survival rate is less than 5%, although early detection and curative resection can improve the survival rate to 20% [1] . Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has high specificity for malignancy in a solid pancreatic lesion, but sensitivity varies from 70% to 90% [2][3][4][5][6][7][8][9][10][11][12][13][14] . This is due to suboptimal sampling and cases of indeterminate cytology.…”

Section: Introductionmentioning

confidence: 99%

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Staining for p53 and Ki-67 increases the sensitivity of EUS-FNA to detect pancreatic malignancy

Jahng

Reicher²,

Chung³

et al. 2010

WJGE

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AIM:To investigate whether tumor marker staining can improve the sensitivity of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) to diagnose pancreatic malignancy. METHODS:Patients who underwent EUS-FNA were retrospectively identified. Each EUS-FNA specimen was evaluated by routine cytology and stained for tumor markers p53, Ki-67, carcinoembryonic antigen (CEA) and CA19-9. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), and positive and negative likelihood ratios (PLR and NLR) were calculated in order to evaluate the performance of each test to detect malignancy. RESULTS:Sixty-one specimens had complete sets of stains, yielding 49 and 12 specimens from pancreatic adenocarcinomas and benign pancreatic lesions due to pancreatitis, respectively. Cytology alone had sensitivity and specificity of 41% and 100% to detect malignancy, respectively. In 46% of the specimens, routine cytology alone was deemed indeterminate. The addition of either p53 or Ki-67 increased the sensitivity to 51% and 53%, respectively, with perfect specificity, PPV and PLR (100%, 100% and infinite). Both stains in combination increased the sensitivity to 57%. While additional staining with CEA and CA19-9 further increased the sensitivity to 86%, the specificity, PPV and PLR were significantly reduced (at minimum 42%, 84% and 1, respectively). Markers in all combinations performed poorly as a negative test (NPV 26% to 47%, and NLR 0.27 and 0.70). CONCLUSION: Immunohistochemical staining for p53and Ki-67 can improve the sensitivity of EUS-FNA to diagnose pancreatic adenocarcinoma.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

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Staining for p53 and Ki-67 increases the sensitivity of EUS-FNA to detect pancreatic malignancy

Jahng

Reicher²,

Chung³

et al. 2010

WJGE

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“…PanINs are commonly found in the pancreatic ducts adjacent to invasive PDAC, and have been regarded as precursor lesions of PDAC (10,18,19). In our study, 12 (60%) of the 20 PDAC cases had PanIN lesions.…”

Section: Discussionmentioning

confidence: 99%

Cytopathologic diagnosis in pleural effusion and cyto-histopathologic correlation

Dağlı¹,

Küçük²,

Sezer³

et al. 2011

TJPATH

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Objective: The majority of the tumors in periampullary region are pancreatic and ampulla of Vater carcinomas. The aim of this study was to compare histopathological features of ampulla of Vater carcinomas with pancreatic ductal adenocarcinomas and to determine diagnostic and predictive values of p16 protein and cyclin D1 expression. Material and Method:Tissue samples from pancreatic ductal adenocarcinomas and ampulla of Vater carcinomas were obtained from 31 patients who underwent pancreticoduodenectomy for periampullary carcinoma. The study group was composed of 12 women and 19 men. Their median age was found to be 62.32 years (range 26-85 years). The parameters analyzed in the study included lymph node metastases, perineural invasion, differentiation, duodenal invasion, grade of intraepithelial neoplasia and p16 and cyclinD1 expression in tumoral and peritumoral pancreatic tissues.Results: in both tumor groups, the loss of p16 protein expression was significantly correlated with perineural invasion (p=0.0001). Perineural invasion was more frequent in the pancreatic ductal adenocarcinoma group than the ampulla of Vater carcinoma group (p=0,01). When desmoplasia and lymphoplasmacytic stromal infiltration were examined, desmoplastic reaction was significantly higher in pancreatic ductal adenocarcinomas than ampulla of Vater carcinomas (p=0.01). no significant difference was observed between tumor groups for Cyclin D1 (p>0.05). Conclusion:The results suggest that loss of p16 protein expression may be a sign for poor prognosis in periampullary cancers that is correlated mainly with perineural invasion. Desmoplastic stromal reaction may be a distinctive feature for pancreatic ductal adenocarcinoma compared with ampulla of Vater carcinoma.

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Capillary Electrophoresis in Clinical ChemistryUpdate based on the original article by Yan Xu,Encyclopedia of Analytical Chemistry, © 2000, John Wiley & Sons, Ltd

Wabuyele

2012

Encyclopedia of Analytical Chemistry

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Clinical chemistry also known as chemical pathology is a discipline that is generally concerned with analysis of biological fluids for diagnosis of human diseases. Capillary electrophoresis (CE) is electrophoretic separation run in narrow‐bore capillary format, which has become a highly efficient and versatile separation technique available for analysis of a wide variety of biologically active molecules. Implementation of CE in clinical laboratories will enhance the capability of the current clinical diagnostic system and improve the efficiency and quality of routine clinical testing. Owing to the nature of clinical diagnostics, the adoption of CE in clinical laboratories has been slow. However, CE has begun to replace some older and antiquated conventional techniques with unique applications in some pioneering clinical laboratories. This review covers a brief introduction to the CE technique (i.e. principle of separation, modes of operation, instrumentation, and practical considerations), and a summary of its applications in clinical chemistry (i.e. proteins, nucleic acids, drugs, and organic and inorganic ions), as well as the future prospects of this field.

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Evaluation of clinical relevance of examining K-ras, p16 and p53 mutations along with allelic losses at 9p and 18q in EUS-guided fine needle aspiration samples of patients with chronic pancreatitis and pancreatic cancer

Cited by 92 publications

References 34 publications

Staining for p53 and Ki-67 increases the sensitivity of EUS-FNA to detect pancreatic malignancy

Staining for p53 and Ki-67 increases the sensitivity of EUS-FNA to detect pancreatic malignancy

Cytopathologic diagnosis in pleural effusion and cyto-histopathologic correlation

Capillary Electrophoresis in Clinical ChemistryUpdate based on the original article by Yan Xu,Encyclopedia of Analytical Chemistry, © 2000, John Wiley & Sons, Ltd

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