Abstract

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.

Details

Title
Molecular analysis of cyst fluids improves the diagnostic accuracy of pre-operative assessment of pancreatic cystic lesions
Author
Haeberle Lena 1 ; Schramm, Martin 1 ; Goering, Wolfgang 1 ; Frohn, Lisa 1 ; Driescher Caroline 1 ; Hartwig, Werner 2 ; Hubert-Karl, Preissinger-Heinzel 2 ; Beyna Torsten 3 ; Neuhaus Horst 3 ; Fuchs Katharina 4 ; Keitel-Anselmino Verena 4 ; Knoefel, Wolfram Trudo 5 ; Esposito, Irene 1 

 Heinrich-Heine University and University Hospital of Duesseldorf, Institute of Pathology, Duesseldorf, Germany (GRID:grid.14778.3d) (ISNI:0000 0000 8922 7789) 
 Department of Surgery, Duesseldorf, Germany (GRID:grid.14778.3d) 
 Evangelisches Krankenhaus, Department of Internal Medicine, Duesseldorf, Germany (GRID:grid.492163.b) (ISNI:0000 0000 8976 5894) 
 Heinrich-Heine University and University Hospital of Duesseldorf, Clinic for Gastroenterology, Hepatology and Infectious Diseases, Duesseldorf, Germany (GRID:grid.14778.3d) (ISNI:0000 0000 8922 7789) 
 Heinrich-Heine University and University Hospital of Duesseldorf, Department of Visceral, Thoracic and Pediatric Surgery, Duesseldorf, Germany (GRID:grid.14778.3d) (ISNI:0000 0000 8922 7789) 
Publication year
2021
Publication date
2021
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2485936974
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.