PMID- 21705950
OWN - NLM
STAT- MEDLINE
DCOM- 20120112
LR  - 20161125
IS  - 1536-4828 (Electronic)
IS  - 0885-3177 (Linking)
VI  - 40
IP  - 7
DP  - 2011 Oct
TI  - Fluorescence in situ hybridization and K-ras analyses improve diagnostic yield of 
      endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic masses.
PG  - 1057-62
LID - 10.1097/MPA.0b013e3182200201 [doi]
AB  - OBJECTIVES: Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) is 
      the main diagnostic modality for pancreatic mass lesions. However, cytology is 
      often indeterminate, leading to repeat FNAs and delay in care. Here, we evaluate 
      whether combining routine cytology with fluorescence in situ hybridization (FISH) 
      and K-ras/p53 analyses improves diagnostic yield of pancreatic EUS-FNA. METHODS: 
      Fifty EUS-FNAs of pancreatic masses in 46 patients were retrospectively analyzed. 
      Mean follow-up was 68 months. Thirteen initial cytologic samples (26%) were 
      benign, 23 malignant (46%), and 14 atypical (28%). We performed FISH for p16, 
      p53, LPL, c-Myc, MALT1, topoisomerase 2/human epidermal growth factor receptor 2, 
      and EGFR, as well as K-ras/p53 mutational analyses. RESULTS: On final diagnosis, 
      11 (79%) of atypical FNAs were malignant, and 3 benign (21%). Fluorescence in 
      situ hybridization was negative in all benign and all atypical samples with final 
      benign diagnosis. Fluorescence in situ hybridization plus K-ras analysis 
      correctly identified 60% of atypical FNAs with final malignant diagnosis. 
      Combination of routine cytology with positive FISH and K-ras analyses yielded 
      87.9% sensitivity, 93.8% specificity, 96.7% positive predictive value, 78.9% 
      negative predictive value, and 89.8% accuracy. CONCLUSIONS: 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.
FAU - Reicher, Sofiya
AU  - Reicher S
AD  - Division of Gastroenterology, Harbor-UCLA Medical Center, Torrance, CA 90502, 
      USA. sreicher@sbcglobal.net
FAU - Boyar, Fatih Z
AU  - Boyar FZ
FAU - Albitar, Maher
AU  - Albitar M
FAU - Sulcova, Vladimira
AU  - Sulcova V
FAU - Agersborg, Sally
AU  - Agersborg S
FAU - Nga, Visal
AU  - Nga V
FAU - Zhou, Ying
AU  - Zhou Y
FAU - Li, Gang
AU  - Li G
FAU - Venegas, Rose
AU  - Venegas R
FAU - French, Samuel W
AU  - French SW
FAU - Chung, David S
AU  - Chung DS
FAU - Stabile, Bruce E
AU  - Stabile BE
FAU - Eysselein, Viktor E
AU  - Eysselein VE
FAU - Anguiano, Arturo
AU  - Anguiano A
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pancreas
JT  - Pancreas
JID - 8608542
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (KRAS protein, human)
RN  - 0 (Proto-Oncogene Proteins)
RN  - 0 (TP53 protein, human)
RN  - 0 (Tumor Suppressor Protein p53)
RN  - EC 3.6.5.2 (Proto-Oncogene Proteins p21(ras))
RN  - EC 3.6.5.2 (ras Proteins)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biomarkers, Tumor/*genetics
MH  - *Biopsy, Fine-Needle
MH  - California
MH  - Chi-Square Distribution
MH  - *DNA Mutational Analysis
MH  - *Endosonography
MH  - Female
MH  - Humans
MH  - *In Situ Hybridization, Fluorescence
MH  - Male
MH  - Middle Aged
MH  - *Mutation
MH  - Pancreatic Diseases/*diagnosis/genetics/pathology
MH  - Pancreatic Neoplasms/*diagnosis/genetics/pathology
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Proto-Oncogene Proteins/*genetics
MH  - Proto-Oncogene Proteins p21(ras)
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - Time Factors
MH  - Tumor Suppressor Protein p53/genetics
MH  - ras Proteins/*genetics
EDAT- 2011/06/28 06:00
MHDA- 2012/01/13 06:00
CRDT- 2011/06/28 06:00
PHST- 2011/06/28 06:00 [entrez]
PHST- 2011/06/28 06:00 [pubmed]
PHST- 2012/01/13 06:00 [medline]
AID - 10.1097/MPA.0b013e3182200201 [doi]
PST - ppublish
SO  - Pancreas. 2011 Oct;40(7):1057-62. doi: 10.1097/MPA.0b013e3182200201.