Moray micro forceps biopsy improves the diagnosis of specific pancreatic cysts
| Autor: | M. Lisa Zhang, David G. Forcione, Ronald Arpin, William R. Brugge, Martha B. Pitman, Ömer Başar |
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| Rok vydání: | 2018 |
| Předmět: |
Cancer Research
Pathology medicine.medical_specialty biology Intraductal papillary mucinous neoplasm business.industry medicine.disease Serous Cystadenoma Cystic Neoplasm 03 medical and health sciences 0302 clinical medicine Carcinoembryonic antigen Oncology Dysplasia 030220 oncology & carcinogenesis medicine GNAS complex locus biology.protein 030211 gastroenterology & hepatology Cyst Pancreatic cysts business |
| Zdroj: | Cancer Cytopathology. 126:414-420 |
| ISSN: | 1934-662X |
| Popis: | Background Making a specific diagnosis of pancreatic cysts preoperatively is difficult. The new disposable Moray micro forceps biopsy (MFB) device allows tissue sampling from the pancreatic cyst wall/septum and aims to improve diagnosis. This study compares the diagnostic performance of the MFB with the current conventional analysis of pancreatic cyst fluid (PCF). Methods A total of 48 patients sampled with MFB were identified. Cysts were classified as mucinous on PCF based on extracellular mucin/mucinous epithelium, carcinoembryonic antigen (CEA) levels ≥192 ng/mL, or KRAS/GNAS mutation. A diagnosis of intraductal papillary mucinous neoplasm was supported by GNAS mutation; a diagnosis of serous cystadenoma was supported by Von Hippel-Lindau tumor suppressor (VHL) mutation. A diagnosis of mucinous cystic neoplasm required the presence of subepithelial ovarian-type stroma. A high-risk cyst was defined as a mucinous cyst with high-grade dysplasia or an adenocarcinoma. Comparisons in diagnostic performance between PCF and MFB were made. Results The mean age of the patients was 69.6 years (range, 27-90 years); 25 of 48 patients (52.1%) were female. Cysts were in the pancreatic head (13 patients), neck (2 patients), body (20 patients), and tail (13 patients), averaging 3.1 cm (range, 1.2-6.0 cm). There was concordance with mucinous versus nonmucinous classification (60.4% for PCF vs 58.3% for MFB; P = .949). Three high-risk cysts were detected by PCF and 2 were detected by MFB (P = .670). However, MFB diagnosed significantly more specific cysts compared with PCF (50.0% for MFB vs 18.8% for PCF; P Conclusions PCF analysis and MFB have comparable performance in distinguishing between mucinous and nonmucinous cysts and for detecting high-risk cysts. However, MFB was found to be superior for diagnosing specific cyst subtypes, thus adding significant value to preoperative patient management. Cancer Cytopathol 2018;126:414-20. © 2018 American Cancer Society. |
| Databáze: | OpenAIRE |
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