Molecular analysis of cyst fluids improves the diagnostic accuracy of pre-operative assessment of pancreatic cystic lesions.

Autor: Haeberle L; Institute of Pathology, Heinrich-Heine University and University Hospital of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany., Schramm M; Institute of Pathology, Heinrich-Heine University and University Hospital of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany., Goering W; Institute of Pathology, Heinrich-Heine University and University Hospital of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany., Frohn L; Institute of Pathology, Heinrich-Heine University and University Hospital of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany., Driescher C; Institute of Pathology, Heinrich-Heine University and University Hospital of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany., Hartwig W; Department of Surgery, Evangelisches Krankenhaus, Duesseldorf, Germany., Preissinger-Heinzel HK; Department of Surgery, Evangelisches Krankenhaus, Duesseldorf, Germany., Beyna T; Department of Internal Medicine, Evangelisches Krankenhaus, Duesseldorf, Germany., Neuhaus H; Department of Internal Medicine, Evangelisches Krankenhaus, Duesseldorf, Germany., Fuchs K; Clinic for Gastroenterology, Hepatology and Infectious Diseases, Heinrich-Heine University and University Hospital of Duesseldorf, Duesseldorf, Germany., Keitel-Anselmino V; Clinic for Gastroenterology, Hepatology and Infectious Diseases, Heinrich-Heine University and University Hospital of Duesseldorf, Duesseldorf, Germany., Knoefel WT; Department of Visceral, Thoracic and Pediatric Surgery, Heinrich-Heine University and University Hospital of Duesseldorf, Duesseldorf, Germany., Esposito I; Institute of Pathology, Heinrich-Heine University and University Hospital of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany. irene.esposito@med.uni-duesseldorf.de.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2021 Feb 03; Vol. 11 (1), pp. 2901. Date of Electronic Publication: 2021 Feb 03.
DOI: 10.1038/s41598-021-81065-2
Abstrakt: Pancreatic cystic lesions (PCL) are increasingly diagnosed. Endoscopic ultrasound fine-needle aspiration (EUS-FNA) cytology is often used for diagnostic confirmation but can be inconclusive. In this study, the role of molecular analyses in the pre-operative diagnostics of PCL is evaluated. Targeted Next Generation Sequencing (NGS) applied on cytology smears was retrospectively evaluated in a cohort of 37 resected PCL. Usefulness of NGS on fresh cyst fluids was tested in a prospective cohort of patients with newly diagnosed PCL (n = 71). In the retrospective cohort, cytology plus NGS displayed higher sensitivity (94.1% vs. 87.1%) and specificity (100% vs. 50%) than cytology alone for the detection of mucinous neoplasms. In the prospective cohort, sensitivity and specificity of conventional cytology alone were 54.2% and 100% for the detection of mucinous neoplasia and 50.0% and 100% for the detection of high-grade dysplasia, respectively. Adding NGS, all lesions which underwent histopathologic verification (12/71, 17%) could be classified without false positive or false negative results regarding the detection of mucinous neoplasm so far. NGS analysis of cfDNA in PCL fluids is feasible and can increase diagnostic accuracy in the detection of mucinous neoplasms compared to cytology alone. However, algorithms for the detection of high-risk lesions need further improvement.
Databáze: MEDLINE
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