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A combination of molecular markers and clinical features improve the classification of pancreatic cysts.
Springer, Simeon; Wang, Yuxuan; Dal Molin, Marco; Masica, David L; Jiao, Yuchen; Kinde, Isaac; Blackford, Amanda; Raman, Siva P; Wolfgang, Christopher L; Tomita, Tyler; Niknafs, Noushin; Douville, Christopher; Ptak, Janine; Dobbyn, Lisa; Allen, Peter J; Klimstra, David S; Schattner, Mark A; Schmidt, C Max; Yip-Schneider, Michele; Cummings, Oscar W; Brand, Randall E; Zeh, Herbert J; Singhi, Aatur D; Scarpa, Aldo; Salvia, Roberto; Malleo, Giuseppe; Zamboni, Giuseppe; Falconi, Massimo; Jang, Jin-Young; Kim, Sun-Whe; Kwon, Wooil; Hong, Seung-Mo; Song, Ki-Byung; Kim, Song Cheol; Swan, Niall; Murphy, Jean; Geoghegan, Justin; Brugge, William; Fernandez-Del Castillo, Carlos; Mino-Kenudson, Mari; Schulick, Richard; Edil, Barish H; Adsay, Volkan; Paulino, Jorge; van Hooft, Jeanin; Yachida, Shinichi; Nara, Satoshi; Hiraoka, Nobuyoshi; Yamao, Kenji; Hijioka, Susuma.
Afiliação
  • Springer S; The Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, The Johns Hopkins University, Baltimore, Maryland; The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University, Baltimore, Maryland.
  • Wang Y; The Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, The Johns Hopkins University, Baltimore, Maryland; The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University, Baltimore, Maryland.
  • Dal Molin M; The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University, Baltimore, Maryland; Department of Pathology, The Johns Hopkins University, Baltimore, Maryland.
  • Masica DL; The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University, Baltimore, Maryland; Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland; The Johns Hopkins Medical Institutions and the Institute for Computational Medicine, The Johns Hopkins Univer
  • Jiao Y; The Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, The Johns Hopkins University, Baltimore, Maryland; The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University, Baltimore, Maryland.
  • Kinde I; The Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, The Johns Hopkins University, Baltimore, Maryland; The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University, Baltimore, Maryland.
  • Blackford A; Department of Biostatistics and Bioinformatics, The Johns Hopkins University, Baltimore, Maryland.
  • Raman SP; Department of Radiology, The Johns Hopkins University, Baltimore, Maryland.
  • Wolfgang CL; The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University, Baltimore, Maryland; Department of Surgery, The Johns Hopkins University, Baltimore, Maryland; Department of Oncology, The Johns Hopkins University, Baltimore, Maryland.
  • Tomita T; Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland; The Johns Hopkins Medical Institutions and the Institute for Computational Medicine, The Johns Hopkins University, Baltimore, Maryland.
  • Niknafs N; Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland; The Johns Hopkins Medical Institutions and the Institute for Computational Medicine, The Johns Hopkins University, Baltimore, Maryland.
  • Douville C; Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland; The Johns Hopkins Medical Institutions and the Institute for Computational Medicine, The Johns Hopkins University, Baltimore, Maryland.
  • Ptak J; The Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, The Johns Hopkins University, Baltimore, Maryland; The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University, Baltimore, Maryland.
  • Dobbyn L; The Ludwig Center and Howard Hughes Medical Institute at the Sidney Kimmel Cancer Center, The Johns Hopkins University, Baltimore, Maryland; The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University, Baltimore, Maryland.
  • Allen PJ; Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
  • Klimstra DS; Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York.
  • Schattner MA; Department of Gastroenterology, Memorial Sloan-Kettering Cancer Center, New York, New York.
  • Schmidt CM; Department of Surgery, University of Indiana, Bloomington, Indiana.
  • Yip-Schneider M; Department of Pathology, University of Indiana, Bloomington, Indiana.
  • Cummings OW; Department of Pathology, University of Indiana, Bloomington, Indiana.
  • Brand RE; Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
  • Zeh HJ; Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
  • Singhi AD; Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania.
  • Scarpa A; ARC-Net Research Centre, Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy; Department of Pathology, General Surgery B, University and Hospital Trust of Verona, Verona, Italy.
  • Salvia R; Department of Surgery, University and Hospital Trust of Verona, Verona, Italy.
  • Malleo G; Department of Surgery, University and Hospital Trust of Verona, Verona, Italy.
  • Zamboni G; Department of Pathology, General Surgery B, University and Hospital Trust of Verona, Verona, Italy; Department of Pathology, Ospedale Sacro Cuore-Don Calabraia, Negrar, Italy.
  • Falconi M; Division of Pancreatic Surgery, Department of Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Jang JY; Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • Kim SW; Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • Kwon W; Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • Hong SM; Departments of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Song KB; Department of Hepatobiliary and Pancreas Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Kim SC; Department of Hepatobiliary and Pancreas Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Swan N; Department of Histopathology, St Vincent's University Hospital, Dublin, Ireland.
  • Murphy J; Department of Histopathology, St Vincent's University Hospital, Dublin, Ireland.
  • Geoghegan J; Department of Surgery, St Vincent's University Hospital, Dublin, Ireland.
  • Brugge W; Department of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts.
  • Fernandez-Del Castillo C; Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
  • Mino-Kenudson M; Department of Histopathology, Massachusetts General Hospital, Boston, Massachusetts.
  • Schulick R; Department of Surgery, University of Colorado, Boulder, Colorado.
  • Edil BH; Department of Surgery, University of Colorado, Boulder, Colorado.
  • Adsay V; Department of Pathology, Emory University, Atlanta, Georgia.
  • Paulino J; Department of Pathology, Centro Hepatobiliopancreático e Transplantação, Hospital Curry Cabral, Lisbon, Portugal.
  • van Hooft J; Department of Gastroenterology and Hepatology, Amsterdam Medical Center, The Netherlands.
  • Yachida S; Department of Hepatobiliary and Pancreatic Surgery, Pathology and Cancer Genomics, National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo, Japan.
  • Nara S; Department of Hepatobiliary and Pancreatic Surgery, Pathology and Cancer Genomics, National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo, Japan.
  • Hiraoka N; Department of Hepatobiliary and Pancreatic Surgery, Pathology and Cancer Genomics, National Cancer Center Hospital and National Cancer Center Research Institute, Tokyo, Japan.
  • Yamao K; Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan.
  • Hijioka S; Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan.
Gastroenterology ; 149(6): 1501-10, 2015 Nov.
Article em En | MEDLINE | ID: mdl-26253305
ABSTRACT
BACKGROUND &

AIMS:

The management of pancreatic cysts poses challenges to both patients and their physicians. We investigated whether a combination of molecular markers and clinical information could improve the classification of pancreatic cysts and management of patients.

METHODS:

We performed a multi-center, retrospective study of 130 patients with resected pancreatic cystic neoplasms (12 serous cystadenomas, 10 solid pseudopapillary neoplasms, 12 mucinous cystic neoplasms, and 96 intraductal papillary mucinous neoplasms). Cyst fluid was analyzed to identify subtle mutations in genes known to be mutated in pancreatic cysts (BRAF, CDKN2A, CTNNB1, GNAS, KRAS, NRAS, PIK3CA, RNF43, SMAD4, TP53, and VHL); to identify loss of heterozygozity at CDKN2A, RNF43, SMAD4, TP53, and VHL tumor suppressor loci; and to identify aneuploidy. The analyses were performed using specialized technologies for implementing and interpreting massively parallel sequencing data acquisition. An algorithm was used to select markers that could classify cyst type and grade. The accuracy of the molecular markers was compared with that of clinical markers and a combination of molecular and clinical markers.

RESULTS:

We identified molecular markers and clinical features that classified cyst type with 90%-100% sensitivity and 92%-98% specificity. The molecular marker panel correctly identified 67 of the 74 patients who did not require surgery and could, therefore, reduce the number of unnecessary operations by 91%.

CONCLUSIONS:

We identified a panel of molecular markers and clinical features that show promise for the accurate classification of cystic neoplasms of the pancreas and identification of cysts that require surgery.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pâncreas / Cisto Pancreático / Algoritmos / Biomarcadores Tumorais Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Gastroenterology Ano de publicação: 2015 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pâncreas / Cisto Pancreático / Algoritmos / Biomarcadores Tumorais Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Gastroenterology Ano de publicação: 2015 Tipo de documento: Article