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Abstract
Detection of circulating tumor DNA (ctDNA) from plasma cell free DNA (cfDNA) has shown promise for diagnosis, therapeutic targeting, and prognosis. This study explores ctDNA detection by next generation sequencing (NGS) and associated clinicopathologic factors in patients with pancreatic adenocarcinoma (PDAC). Patients undergoing surgical exploration or resection of pancreatic lesions were enrolled with informed consent. Plasma samples (4–6 ml) were collected prior to surgery and cfDNA was recovered from 95 plasma samples. Adequate cfDNA for NGS (20 ng) was obtained from 81 patients. NGS was performed using the Oncomine Lung cfDNA assay on the Ion Torrent S5 sequencing platform. Twenty-five patients (30.9%) had detectable mutations in KRAS and/or TP53 with allele frequencies ranging from 0.05 to 8.5%, while mutations in other genes were detected less frequently and always along with KRAS or TP53. Detectable ctDNA mutations were more frequent in patients with poorly differentiated tumors, and patients without detectable ctDNA mutations showed longer survival (medians of 10.5 months vs. 18 months, p = 0.019). The detection of circulating tumor DNA in pancreatic adenocarcinomas is correlated with worse survival outcomes.
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1 NorthShore University Health System, Department of Pathology and Laboratory Medicine, Evanston, USA (GRID:grid.240372.0) (ISNI:0000 0004 0400 4439); Chulalongkorn University Faculty of Medicine, Department of Pathology, Bangkok, Thailand (GRID:grid.7922.e) (ISNI:0000 0001 0244 7875)
2 NorthShore University Health System, Department of Pathology and Laboratory Medicine, Evanston, USA (GRID:grid.240372.0) (ISNI:0000 0004 0400 4439)
3 University of Michigan School of Medicine, Department of Pathology, Ann Arbor, USA (GRID:grid.214458.e) (ISNI:0000 0004 1936 7347)
4 NorthShore University Health System, Department of Surgery, Evanston, USA (GRID:grid.412489.2) (ISNI:0000 0004 0608 2801)
5 Northwestern University School of Medicine, Chicago, USA (GRID:grid.16753.36) (ISNI:0000 0001 2299 3507)