期刊
CANCER CYTOPATHOLOGY
卷 128, 期 11, 页码 840-851出版社
WILEY
DOI: 10.1002/cncy.22315
关键词
endoscopic ultrasound-guided fine needle aspiration; DNA; pancreatic carcinoma; pancreatic ductal carcinoma; pancreatic neoplasms; sequence analysis
资金
- Translational Research Program, Department of Pathology and Laboratory Medicine, Weill-Cornell Medicine
Background Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is a sensitive and specific tool in the risk stratification of pancreatic lesions, including cysts. The sensitivity and specificity of EUS-FNA has been shown to improve when cytology is combined with next-generation sequencing (NGS). Ideally, fresh cyst fluid is used for NGS. In this pilot study, we explore the possibility of sequencing DNA derived from residual alcohol-fixed pancreatic aspirates. Methods Residual cytologic fixatives (n = 42) from 39 patients who underwent EUS-FNA for pancreatic lesions were collected along with demographics, imaging, and laboratory studies. Samples were designated as nonneoplastic/nonmucinous benign (NB), mucinous cyst (MC), pancreatic ductal adenocarcinoma (PDAC), or well-differentiated neuroendocrine tumor (NET) on the basis of cytopathologic evaluation and sequenced on the Oncomine platform (ThermoFisher Scientific, Waltham, Massachusetts). Results Ten of 14 (71.4%) MCs exhibited clinically significant variants, includingKRAS,GNAS, andTP53. Ten of 15 (66.7%) PDACs hadKRASalterations, and 9 of 15 (60%) showed variants inTP53. No variants were detected in any NETs. Only 1 of 9 (11.1%) NB aspirates showed variants inKRASandMAP2K. Sequencing of formalin-fixed, paraffin-embedded tissue revealed variants identical to those detected in fixative-derived DNA in 4 of 5 cases (80%). Conclusion Residual DNA from alcohol-fixed aspirates are an underutilized source for NGS. Sequencing residual fixative-derived DNA has the potential to be integrated into the workup of pancreatic aspirates, possibly impacting management.
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