Molecular analysis of cyst fluids improves the diagnostic accuracy of pre-operative assessment of pancreatic cystic lesions.
Adolescent
Adult
Aged
Aged, 80 and over
Circulating Tumor DNA
/ analysis
Cyst Fluid
/ chemistry
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Feasibility Studies
Female
High-Throughput Nucleotide Sequencing
Humans
Male
Middle Aged
Pancreas
/ diagnostic imaging
Pancreatic Cyst
/ diagnosis
Pancreatic Neoplasms
/ complications
Preoperative Period
Prospective Studies
Retrospective Studies
Sensitivity and Specificity
Young Adult
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
03 02 2021
03 02 2021
Historique:
received:
09
06
2020
accepted:
24
12
2020
entrez:
4
2
2021
pubmed:
5
2
2021
medline:
16
11
2021
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 33536452
doi: 10.1038/s41598-021-81065-2
pii: 10.1038/s41598-021-81065-2
pmc: PMC7858638
doi:
Substances chimiques
Circulating Tumor DNA
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
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