PMID- 27995180
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 4
IP  - 12
DP  - 2016 Dec
TI  - Endoscopic ultrasound-guided fine-needle aspiration plus KRAS and GNAS mutation 
      in malignant intraductal papillary mucinous neoplasm of the pancreas.
PG  - E1228-E1235
AB  - Background:KRAS and GNAS mutations are common in intraductal papillary mucinous 
      neoplasia of the pancreas (IPMN). The aims of this study were to assess the role 
      of pre-therapeutic cytopathology combined with KRAS and GNAS mutation assays 
      within cystic fluid sampled by endoscopic ultrasound-guided fine-needle 
      aspiration (EUS-FNA) to predict malignancy of IPMN. Patients and methods: We 
      prospectively included 37 IPMN patients with clinical and/or imaging predictors 
      of malignancy (men: 24; mean age: 69.5 years). Cytopathology (performed on cystic 
      fluid and/or IPMN nodules), KRAS (Exon 2, codon 12) and GNAS (Exon 8, codon 201) 
      mutations assays (using TaqMan((R)) allelic discrimination) were performed on 
      EUS-FNA material. The final diagnosis was obtained from IPMN resections (n = 18); 
      surgical biopsies, EUS-FNA analyses, and follow-up (n = 19): 10 and 27 IPMN were 
      benign and malignant, respectively. Results: Sensitivity, specificity, positive 
      and negative predictive values, and accuracy of cytopathology alone to diagnose 
      IPMN malignancy were 55 %, 100 %, 100 %, 45 %, and 66 %, respectively. When 
      KRAS-mutation analysis was combined with cytopathology these values were 92 %, 
      50 %, 83 %, 71 %, and 81 %, respectively. GNAS assays did not improve the 
      performances of cytopathology alone or those of cytopathology plus a KRAS assay. 
      Conclusions: In patients with a likelihood of malignant IPMN at pre-therapeutic 
      investigation, testing for KRAS mutations in cystic fluid sampling by EUS-FNA 
      improved the results of cytopathology for the diagnosis of malignancy whereas 
      GNAS mutation assay did not.
FAU - Bournet, Barbara
AU  - Bournet B
AD  - Department of Gastroenterology and INSERM UMR 1037, CHU Toulouse Rangueil, 
      University of Toulouse, Toulouse, France; INSERM UMR 1037, University Institute 
      of Cancer of Toulouse, University of Toulouse, Toulouse, France.
FAU - Vignolle-Vidoni, Alix
AU  - Vignolle-Vidoni A
AD  - INSERM UMR 1037, University Institute of Cancer of Toulouse, University of 
      Toulouse, Toulouse, France.
FAU - Grand, David
AU  - Grand D
AD  - Department of Pathology, University Institute of Cancer of Toulouse, University 
      of Toulouse, Toulouse, France.
FAU - Roques, Celine
AU  - Roques C
AD  - Department of Pathology, University Institute of Cancer of Toulouse, University 
      of Toulouse, Toulouse, France.
FAU - Breibach, Florence
AU  - Breibach F
AD  - Department of Pathology, University Institute of Cancer of Toulouse, University 
      of Toulouse, Toulouse, France.
FAU - Cros, Jerome
AU  - Cros J
AD  - Department of Pathology, Beaujon Hospital, University of Paris Diderot, Clichy, 
      France.
FAU - Muscari, Fabrice
AU  - Muscari F
AD  - Department of Digestive Surgery, CHU Toulouse Rangueil, University of Toulouse, 
      Toulouse, France.
FAU - Carrere, Nicolas
AU  - Carrere N
AD  - INSERM UMR 1037, University Institute of Cancer of Toulouse, University of 
      Toulouse, Toulouse, France; Department of Digestive Surgery, CHU Toulouse Purpan, 
      University of Toulouse, Toulouse, France.
FAU - Selves, Janick
AU  - Selves J
AD  - INSERM UMR 1037, University Institute of Cancer of Toulouse, University of 
      Toulouse, Toulouse, France; Department of Pathology, University Institute of 
      Cancer of Toulouse, University of Toulouse, Toulouse, France.
FAU - Cordelier, Pierre
AU  - Cordelier P
AD  - INSERM UMR 1037, University Institute of Cancer of Toulouse, University of 
      Toulouse, Toulouse, France.
FAU - Buscail, Louis
AU  - Buscail L
AD  - Department of Gastroenterology and INSERM UMR 1037, CHU Toulouse Rangueil, 
      University of Toulouse, Toulouse, France; INSERM UMR 1037, University Institute 
      of Cancer of Toulouse, University of Toulouse, Toulouse, France.
LA  - eng
PT  - Journal Article
DEP - 20161110
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC5161125
COIS- Competing interests: Financial support received from STIC Program Inca 2008, Inca 
      PRK 2012 and gifts from A. C., M-H. C. and L. G.
EDAT- 2016/12/21 06:00
MHDA- 2016/12/21 06:01
PMCR- 2016/12/01
CRDT- 2016/12/21 06:00
PHST- 2016/02/20 00:00 [received]
PHST- 2016/08/19 00:00 [accepted]
PHST- 2016/12/21 06:00 [entrez]
PHST- 2016/12/21 06:00 [pubmed]
PHST- 2016/12/21 06:01 [medline]
PHST- 2016/12/01 00:00 [pmc-release]
AID - 10.1055/s-0042-117216 [doi]
PST - ppublish
SO  - Endosc Int Open. 2016 Dec;4(12):E1228-E1235. doi: 10.1055/s-0042-117216. Epub 
      2016 Nov 10.