Fluorescence In Situ Hybridization and K-ras Analyses Improve Diagnostic Yield of Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Solid Pancreatic Masses

Reicher, Sofiya; Boyar, Fatih Z; Albitar, Mäher; Sulcova, Vladimira; Agersborg, Sally; Nga, Visal; Zhou, Ying; Li, Gang; Venegas, Rose; French, Samuel W.; Chung, Denise; Stabile, Bruce E.; Eysselein, Viktor E.; Anguiano, Arturo

doi:10.1097/mpa.0b013e3182200201

Cited by 39 publications

(30 citation statements)

References 35 publications

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“…[232425] The majority of studies involving KRAS mutations have investigated their relationship with pancreatic adenocarcinoma[26272829] and genetic progression in pancreatic duct lesions and intraductal papillary mucinous neoplasms (IPMN). [303132] KRAS mutational analysis of pancreatic juice has even been used as a potential method for the early diagnosis of pancreatic carcinoma.…”

Section: Molecular Analysis Of Duct Stricture Brushing Specimensmentioning

confidence: 99%

“…[303132] KRAS mutational analysis of pancreatic juice has even been used as a potential method for the early diagnosis of pancreatic carcinoma. [333435] Although KRAS mutations can be found in pre-invasive dysplastic lesions and invasive carcinomas of the pancreas,[2324252627282930] several studies have shown that KRAS mutation analysis is a sensitive test for pancreatic adenocarcinoma. [363738] Sturm et al .…”

Section: Molecular Analysis Of Duct Stricture Brushing Specimensmentioning

confidence: 99%

“…[2728] Reicher et al . [23] have demonstrated some utility for KRAS mutational analysis in the evaluation of endoscopic ultrasound (EUS)-FNA specimens. They described KRAS mutations in approximately 9% of benign specimens and 56% of malignant specimens.…”

Section: Molecular Analysis Of Duct Stricture Brushing Specimensmentioning

confidence: 99%

“…Neither of the two cases in Reicher's study considered cytologically atypical but on follow-up demonstrated to be benign, contained KRAS mutations. [23] On the other hand, in cases considered atypical with malignant follow-up, 20% of cases (2/10) demonstrated KRAS mutations. Additional studies will be necessary to determine the value of KRAS mutational analysis in both bile duct stricture cytology samples and FNA of solid pancreatic masses, but current data do not support KRAS testing of solid pancreatic masses and bile duct strictures as a useful ancillary test for diagnosis.…”

Section: Molecular Analysis Of Duct Stricture Brushing Specimensmentioning

confidence: 99%

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Utilization of ancillary studies in the cytologic diagnosis of biliary and pancreatic lesions: The Papanicolaou Society of Cytopathology Guidelines

et al. 2014

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The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound guided fine needle aspiration, terminology and nomenclature of pancreatobiliary disease, ancillary testing and post-biopsy management. All documents are based on the expertise of the authors, a review of the literature, discussion of the draft document at several national and international meetings and synthesis of selected online comments of the draft document. This document presents the results of these discussions regarding the use of ancillary testing in the cytologic diagnosis of biliary and pancreatic lesions. Currently, fluorescence in-situ hybridization (FISH) appears to be the most clinically relevant ancillary technique for cytology of bile duct strictures. The addition of FISH analysis to routine cytologic evaluation appears to yield the highest sensitivity without loss in specificity. Loss of immunohistochemical staining for the protein product of the SMAD4 gene and positive staining for mesothelin support a diagnosis of ductal adenocarcinoma. Immunohistochemical markers for endocrine and exocrine differentiation are sufficient for a diagnosis of endocrine and acinar tumors. Nuclear staining for beta-catenin supports a diagnosis of solid-pseudopapillary neoplasm. Cyst fluid analysis for amylase and carcinoembryonic antigen aids in the pre-operative classification of pancreatic cysts. A number of gene mutations (KRAS, GNAS, von Hippel-Lindau, RNF43 and CTNNB1) may be of aid in the diagnosis of cystic neoplasms. Other ancillary techniques do not appear to improve diagnostic sensitivity sufficiently to justify their increased costs.

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Section: Molecular Analysis Of Duct Stricture Brushing Specimensmentioning

confidence: 99%

Section: Molecular Analysis Of Duct Stricture Brushing Specimensmentioning

confidence: 99%

Section: Molecular Analysis Of Duct Stricture Brushing Specimensmentioning

confidence: 99%

Section: Molecular Analysis Of Duct Stricture Brushing Specimensmentioning

confidence: 99%

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Utilization of ancillary studies in the cytologic diagnosis of biliary and pancreatic lesions: The Papanicolaou Society of Cytopathology Guidelines

et al. 2014

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“…We are of the opinion that a larger and multicenter patient population could elucidate further the EUS features of pNETs and we believe that a confirmation of our original data could increase the clinical relevance of this set of observations. Over and above the pNETs ultrasonographic characteristics observed through EUS, such a sensitive and specific investigation also represents a reliable and effective support for performing a lesion biopsy, with an obvious subsequent clinically relevant impact in terms of diagnostic characterization, pathogenetic definition, and prognosis of the pNET [25-27]. Moreover, EUS can also be associated to radiofrequency ablation of pancreatic tumors, including those of neuroendocrine origin [28].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Ultrasound Features of Multiple Endocrine Neoplasia Type 1-Related versus Sporadic Pancreatic Neuroendocrine Tumors: A Single-Center Retrospective Study

Tamagno

Scherer

Caimo³

et al. 2018

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Aim: Pancreatic neuroendocrine tumors (pNETs) can occur in patients with a familial syndrome either as multiple endocrine neoplasia type 1 (MEN-1) or as sporadic tumors. Endoscopic ultrasound (EUS) has become one of the first-line investigations for pNET characterization. The ultrasonographic features of pNETs may differ depending on the familial versus sporadic pathogenesis of the tumor. Therefore, the EUS findings could help and direct the definition of a pNET with an impact on the most appropriate diagnostic and therapeutic patient management. Methods: In this single-center retrospective study, we reviewed the EUS features of 94 pNETs from 37 MEN-1 patients and 15 pNETs from 11 sporadic disease patients at the time of their first EUS assessment. We analyzed the most relevant morphological and ultrasonographic characteristics of the tumors and compared the findings between the 2 patient groups. Results: Patients with MEN-1 more likely present with multiple pNETs than patients with sporadic disease. Sporadic pNETs are usually much bigger than those due to MEN-1. Moreover, pNETs are more heterogeneous in patients with sporadic disease than in those with MEN-1. No statistical difference with regard to definition of the margins, morphology, and vascularization of the pNETs appears between the 2 groups. Conclusions: Patients with sporadic disease usually present with bigger and more heterogeneous pNETs than patients with MEN-1, who tend to present with a higher number of lesions. EUS can facilitate the precise characterization of a pNET, and the ultrasonographic features of the lesion can help and distinguish MEN-1-related versus sporadic disease.

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Imaging modalities for characterising focal pancreatic lesions

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Rawji

Pereira

et al. 2017

Cochrane Database of Systematic Reviews

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Fluorescence In Situ Hybridization and K-ras Analyses Improve Diagnostic Yield of Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Solid Pancreatic Masses

Abstract: Combining routine cytology with FISH and K-ras analyses improves diagnostic yield of EUS-FNA of solid pancreatic masses. We propose to include these ancillary tests in the workup of atypical cytology from pancreatic EUS-FNA.

Cited by 39 publications

References 35 publications

Utilization of ancillary studies in the cytologic diagnosis of biliary and pancreatic lesions: The Papanicolaou Society of Cytopathology Guidelines

Utilization of ancillary studies in the cytologic diagnosis of biliary and pancreatic lesions: The Papanicolaou Society of Cytopathology Guidelines

Endoscopic Ultrasound Features of Multiple Endocrine Neoplasia Type 1-Related versus Sporadic Pancreatic Neuroendocrine Tumors: A Single-Center Retrospective Study

Imaging modalities for characterising focal pancreatic lesions

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