| Kras mutation analysis of fine needle aspirate under EUS guidance facilitates risk stratification of patients with pancreatic mass. | |
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MedLine Citation:
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PMID: 18090159 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The accuracy of endoscopic ultrasound-fine needle aspiration cytology (EUS-FNAC) for the diagnosis of pancreatic cancer is suboptimal. Mutational activation of the kras oncogene is almost universally present in pancreatic cancer tissue. We, therefore, investigated if analysis for mutant kras gene in the EUS-FNAC aspirates supplements cytopathology for the diagnosis of pancreatic adenocarcinoma (PAC). METHODS: EUS-FNAC specimens obtained from 74 patients with pancreatic masses were analyzed for the presence of kras mutation on codon 12 using polymerase chain reaction-restriction fragment length polymorphism and MvaI restriction enzyme. Definitive diagnosis was based on surgical pathology or long-term follow-up (median 27.8 mo); 57 patients had PAC, 11 patient's chronic pancreatitis, and 9 patient's nonfunctioning neuroendocrine tumors. RESULTS: Analysis of mutant kras gene in addition to cytopathology allowed the detection of PAC in 4 additional patients as compared with cytopathology alone. Cytopathology and kras mutant analysis were negative for PAC in 17 patients of whom 6 patients (35%) had PAC. The respective sensitivity (90.9% vs. 82.5%), specificity (47.6% vs. 97.9%), positive predictive value (89.5% vs. 83.8%), negative predictive value (98.1% vs. 94.1%), accuracy (89.2% vs. 58.8%) of cytopathology plus kras mutation versus cytopathology were numerically superior but did not reach statistical significance. CONCLUSIONS: Analysis for the presence of mutant kras gene supplements conventional cytopathology for the diagnosis of PAC even without a cytopathologist in attendance and using only 3 needle passes. Among patients with negative cytopathology, the presence of kras mutation represents pancreatic cancer while the absence of kras mutation increases the possibility of benign lesion. |
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Authors:
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Fauze Maluf-Filho; Atul Kumar; René Gerhardt; Márcia Kubrusly; Paulo Sakai; Fabio Hondo; Sergio Eiji Matuguma; Everson Artifon; José Eduardo Monteiro da Cunha; Marcel Cerqueira César Machado; Shinichi Ishioka; Elias Forero |
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Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Journal of clinical gastroenterology Volume: 41 ISSN: 0192-0790 ISO Abbreviation: J. Clin. Gastroenterol. Publication Date: 2007 Nov-Dec |
Date Detail:
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Created Date: 2007-12-19 Completed Date: 2008-01-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7910017 Medline TA: J Clin Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 906-10 Citation Subset: IM |
Affiliation:
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Gastrointestinal Endoscopy Division, University of São Paulo School of Medicine, São Paulo, Brazil. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenocarcinoma
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diagnosis*,
genetics,
pathology Adult Aged Biopsy, Fine-Needle Cytodiagnosis Endosonography / methods* Female Humans Male Middle Aged Mutation* Pancreas / pathology* Pancreatic Neoplasms / diagnosis*, genetics, pathology Polymerase Chain Reaction Polymorphism, Restriction Fragment Length Predictive Value of Tests Proto-Oncogene Proteins / genetics* Sensitivity and Specificity ras Proteins / genetics* |
| Chemical | |
Reg. No./Substance:
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0/KRAS protein, human; 0/Proto-Oncogene Proteins; EC 3.6.5.2/ras Proteins |
| Comments/Corrections | |
Comment In:
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J Clin Gastroenterol. 2007 Nov-Dec;41(10):869-70
[PMID:
18090153
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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