Pancreatic endocrine tumor EUS-guided FNA DNA microsatellite loss and mortality
| Autor: | Robyn T. Domsic, Asif Khalid, Michael K. Sanders, Kenneth E. Fasanella, Debra Brody, Kevin McGrath |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Pancreatic disease Biopsy Fine-Needle Loss of Heterozygosity Context (language use) Kaplan-Meier Estimate Gastroenterology Endosonography Metastasis Pancreatic tumor Interquartile range Internal medicine Epidemiology medicine Humans Radiology Nuclear Medicine and imaging Pancreas Ultrasonography Interventional Aged Neoplasm Staging High-power field Aged 80 and over business.industry Retrospective cohort study Middle Aged Prognosis medicine.disease Surgery Pancreatic Neoplasms Ki-67 Antigen Disease Progression Carcinoma Islet Cell Female business Follow-Up Studies |
| Zdroj: | Gastrointestinal Endoscopy. 69:1074-1080 |
| ISSN: | 0016-5107 |
| Popis: | The clinical course of pancreatic endocrine tumors (PET) depends on tumor size, the presence of invasion or metastasis, the Ki-67 index, mitoses per high power field, and mutational damage. Most of this information is not available before surgery for clinical decision making or prognostication.To evaluate PET EUS-guided FNA (EUS-FNA) microsatellite loss analysis in the context of PET-related mortality.A single institution retrospective cohort.Patients with PET diagnosed by EUS-FNA who underwent DNA microsatellite loss analysis and at least 1 year of follow-up or subsequent death.PET microsatellite loss analysis results and current clinical status were compared.Twenty-nine patients were included in the final analysis; the mean age of the patients was 57 years, and 10 were women (35%). The mean follow-up was 33.7 months (median 30 months, range 2-66 months). Twelve patients had disease progression, and 8 died, all from disease-specific causes. Malignant PET contained multiple microsatellite losses, with a median fractional allelic loss (FAL) of 0.37 (range 0.12-0.69, interquartile range [IQR] 0.23-0.42), significantly different from benign PET, median FAL 0 (range 0-0.18, IQR 0-0.08, P.0001). Survival analysis revealed a significant difference in disease recurrence or progression at 2 years (P.0001) and in the 5-year survival between patients with FAL/=0.2 compared with0.2 (P.0001). Logistic regression could not be performed because of the perfect association between an FAL0.2 and disease status or mortality.Retrospective design, referral bias, and DNA analysis availability.PET EUS-FNA microsatellite loss analysis provides preoperative prognostic information. An FAL0.2 is not only associated with disease progression but also with mortality. |
| Databáze: | OpenAIRE |
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