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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
A Combination of Molecular Markers and Clinical Features Improve the Classification of Pancreatic Cysts
Gastroenterology, Volume 149, No. 6, Year 2015
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Description
Background and 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. © 2015 AGA Institute.
Authors & Co-Authors
Wang, Yuxuan
United States, Chevy Chase
Howard Hughes Medical Institute
United States, Baltimore
Johns Hopkins University
Blackford, Amanda Lapides
United States, Baltimore
Johns Hopkins University
Wolfgang, Christopher Lee
United States, Baltimore
Johns Hopkins University
Ptak, Janine B.
United States, Chevy Chase
Howard Hughes Medical Institute
United States, Baltimore
Johns Hopkins University
Dobbyn, Lisa
United States, Chevy Chase
Howard Hughes Medical Institute
United States, Baltimore
Johns Hopkins University
Klimstra, David S.
United States, New York
Memorial Sloan-kettering Cancer Center
Cummings, Oscar William
United States, Bloomington
Indiana University Bloomington
Brand, Randall E.
United States, Pittsburgh
University of Pittsburgh
Zeh, Herbert J.
United States, Pittsburgh
University of Pittsburgh
Singhi, Aatur D.
United States, Pittsburgh
University of Pittsburgh
Scarpa, Aldo
Italy, Verona
University and Hospital Trust of Verona
Salvia, Roberto
Italy, Verona
University and Hospital Trust of Verona
Malleo, Giuseppe
Italy, Verona
University and Hospital Trust of Verona
Falconi, Massimo
Italy, Milan
Irccs Ospedale San Raffaele
Kim, Sunwhe
South Korea, Seoul
Seoul National University
Kim, Song-cheol
South Korea, Seoul
Asan Medical Center
Brugge, William Robert
United States, Boston
Massachusetts General Hospital
Castillo, Carlos Fernández del
United States, Boston
Massachusetts General Hospital
Schulick, Richard D.
United States, Boulder
University of Colorado Boulder
Adsay, Nazmi Volkan
United States, Atlanta
Emory University
Yamao, Kenji
Japan, Nagoya
Aichi Cancer Center Hospital and Research Institute
Hijioka, Susumu
Japan, Nagoya
Aichi Cancer Center Hospital and Research Institute
van der Merwe, Schalk Willem
Belgium, Leuven
Ku Leuven
Eshleman, James Richard
United States, Chevy Chase
Howard Hughes Medical Institute
United States, Baltimore
Johns Hopkins University
Papadopoulos, Nickolas
United States, Chevy Chase
Howard Hughes Medical Institute
United States, Baltimore
Johns Hopkins University
Kinzler, Kenneth W.
United States, Chevy Chase
Howard Hughes Medical Institute
United States, Baltimore
Johns Hopkins University
Hruban, Ralpha Hruban
United States, Chevy Chase
Howard Hughes Medical Institute
United States, Baltimore
Johns Hopkins University
Vogelstein, Bert
United States, Chevy Chase
Howard Hughes Medical Institute
United States, Baltimore
Johns Hopkins University
Lennon, Anne Marie
United States, Chevy Chase
Howard Hughes Medical Institute
United States, Baltimore
Johns Hopkins University
Statistics
Citations: 328
Authors: 29
Affiliations: 19
Identifiers
Doi:
10.1053/j.gastro.2015.07.041
ISSN:
00165085
Research Areas
Cancer
Health System And Policy
Study Design
Cohort Study