Mo1438 Fluid Genetic Analyses Predict Biological Behavior of Pancreatic Cysts: 3-Year Experience

Kung, Jonathan; Lopez, Oscar A.; McCoy, Erin; Reicher, Sofiya; Eysselein, Viktor E.

doi:10.1016/j.gie.2014.02.615

Cited by 6 publications

(8 citation statements)

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“…Nevertheless, this would probably not have affected the results because the patients included in our cohort were sent for EUS-FNA after inconclusive CT and MRI. (3) We did not include in our study new PCLs diagnostic tools for which the potential interests have been published during the conduct of the study, including DNA mutations [25,26], string sign tests [27], and EUS-guided microforceps biopsies [28]. (4) For the sake of simplification, therapeutic management was based on a consensus of a panel of five experts.…”

Section: Discussionmentioning

confidence: 99%

Impact of needle-based confocal laser endomicroscopy on the therapeutic management of single pancreatic cystic lesions

et al. 2019

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Background and aim The diagnosis and therapeutic management of large single pancreatic cystic lesions (PCLs) represent major issues for clinicians and essentially rely on endoscopic ultrasound fine-needle aspiration (EUS-FNA) findings. Needlebased confocal laser endomicroscopy (nCLE) has high diagnostic performance for PCLs. This study aimed to evaluate the impact of nCLE on the therapeutic management of patients with single PCLs. Methods Retrospective and comparative study. Five independent pancreatic disease experts from tertiary hospitals independently reviewed data from a prospective database of 206 patients with single PCL, larger than 2 cm and who underwent EUS-FNA and nCLE. Two evaluations were performed. The first one included the sequential review of clinical information, EUS report and FNA results. The second one included the same data + nCLE report. Participants had to propose a therapeutic management for each case. Results The addition of nCLE to EUS-FNA led to significant changes in therapeutic management for 28% of the patients (p < 0.001). nCLE significantly increased the interobserver agreement of 0.28 (p < 0.0001), from 0.36 (CI 95% 0.33-0.49) to 0.64 (CI 95% 0.61-0.67). nCLE improved the rates of full agreement among the five experts of 24% (p < 0.0001), from 30 to 54%. With nCLE, the surveillance rate of benign SCAs fell by 35%, from 40 (28/70) to 5% (4/76). Conclusion The addition of nCLE to EUS-FNA significantly improves reliability of PCL diagnosis and could impact the therapeutic management of patients with single PCLs. ClinicalTrials.gov number, NCT01563133.Keywords EUS-FNA · Pancreatic cysts · Needle-based confocal laser endomicroscopy Abbreviations BD-IPMN Branch duct-intraductal papillary mucinous neoplasm CT Computed tomography CEA Carcinoembryonic antigen EUS-FNA Endoscopic ultrasound fine-needle aspiration IML Indeterminate mucinous lesion MCN Mucinous cystic neoplasm MRI Magnetic resonance imaging nCLE Needle-based confocal laser endomicroscopy NEN Neuroendocrine neoplasm PC Pseudocyst PCLs Pancreatic cystic lesions SCA Serous cystadenoma The therapeutic management of pancreatic cystic lesions (PCL) depends on the cyst type. Surveillance or surgical and Other Interventional TechniquesPublisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Section: Discussionmentioning

confidence: 99%

Impact of needle-based confocal laser endomicroscopy on the therapeutic management of single pancreatic cystic lesions

et al. 2019

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“…Molecular analysis of pancreatic cysts is an evolving tool for the evaluation of pancreatic cysts and has been shown to aid in the preoperative diagnosis. 23,[25][26][27][38][39][40][41][42] Our study investigated the impact of NGS on the presumptive clinical diagnosis of pancreatic cysts based on imaging features and clinical diagnosis based on CEA levels of the fluid. Our data show that NGS analysis of pancreatic cyst fluid changed the imaging diagnosis in 12% of patients, thus affecting patient management.…”

Section: Discussionmentioning

confidence: 99%

“…21,22 However, studies have shown that in the setting of a pancreatic cyst, a KRAS mutation is very specific for a mucinous etiology. [23][24][25][26] Similarly, GNAS mutations may be detected in PDAC, but in the setting of cyst fluid analysis, a GNAS mutation supports the imaging diagnosis of intraductal papillary mucinous neoplasm (IPMN), whereas the detection of the von Hippel-Lindau gene supports a serous cystadenoma. [27][28][29][30] The development of next-generation sequencing (NGS) enables rapid detection of mutations in a selected panel of cancer genes.…”

mentioning

confidence: 99%

Impact of next-generation sequencing on the clinical diagnosis of pancreatic cysts

Jones

Zheng

Wang

et al. 2016

Gastrointestinal Endoscopy

118

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“…Similarly, molecular mutation analyses in cystic neoplasia of the pancreas and of thyroid lesions of indeterminate cytology can be used to help differentiate benign from malignant lesions [16][17][18][19][20][21][22][23][24][25] . In suspected Stratification of cancer has now become a part of the primary diagnosis.…”

Section: Importance Of Molecular Diagnosis In Oncologymentioning

confidence: 99%

The Spectrum of Clinical Utilities in Molecular Pathology Testing Procedures for Inherited Conditions and Cancer

Joseph

Cankovic

Caughron³

et al. 2016

The Journal of Molecular Diagnostics

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Mo1438 Fluid Genetic Analyses Predict Biological Behavior of Pancreatic Cysts: 3-Year Experience

Cited by 6 publications

References 0 publications

Impact of needle-based confocal laser endomicroscopy on the therapeutic management of single pancreatic cystic lesions

Impact of needle-based confocal laser endomicroscopy on the therapeutic management of single pancreatic cystic lesions

Impact of next-generation sequencing on the clinical diagnosis of pancreatic cysts

The Spectrum of Clinical Utilities in Molecular Pathology Testing Procedures for Inherited Conditions and Cancer

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