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Pancreatic intraductal sampling during ERCP in patients with chronic pancreatitis and pancreatic cancer: cytologic studies and k-ras-2 codon 12 molecular analysis in 47 cases.
Gastrointest Endosc. 2001 Nov; 54(5):595-9.GE

Abstract

BACKGROUND

A preoperative tissue diagnosis of pancreatic cancer is desirable but difficult to obtain.

METHODS

Pancreatic brush cytology, salvage cytology, and collection of pancreatic juice were attempted prospectively during ERCP in 34 patients with pancreatic cancer and 11 with chronic pancreatitis. K-ras-2 codon 12 was analyzed for presence and type of point mutations.

RESULTS

Brush cytology coupled with salvage cytology had a sensitivity of 74%. The addition of cytologic analysis of pancreatic juice did not substantially improve sensitivity (76%). K-ras-2 was mutated in both cancer (87%) and pancreatitis (40%). The specificity for cytology was 100% and for K-ras-2 mutations 60%. Combining cytology with mutation analysis increased sensitivity to 93% but reduced the positive predictive value. The negative predictive value never exceeded 75%. None of the patients with chronic pancreatitis had cancer develop (median follow-up 60 months).

CONCLUSIONS

Pancreatic ductal brushing with salvage cytology is useful in the diagnosis of cancer, whereas cytologic analysis of pancreatic juice can be abandoned. At present, K-ras-2 mutation is not useful for differentiating pancreatic cancer from chronic pancreatitis or the identification of patients with chronic pancreatitis at risk for malignant transformation.

Authors+Show Affiliations

Center for Gastrointestinal Endoscopy, the Department of Oncology, University of Genoa, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11677475

Citation

Pugliese, V, et al. "Pancreatic Intraductal Sampling During ERCP in Patients With Chronic Pancreatitis and Pancreatic Cancer: Cytologic Studies and K-ras-2 Codon 12 Molecular Analysis in 47 Cases." Gastrointestinal Endoscopy, vol. 54, no. 5, 2001, pp. 595-9.
Pugliese V, Pujic N, Saccomanno S, et al. Pancreatic intraductal sampling during ERCP in patients with chronic pancreatitis and pancreatic cancer: cytologic studies and k-ras-2 codon 12 molecular analysis in 47 cases. Gastrointest Endosc. 2001;54(5):595-9.
Pugliese, V., Pujic, N., Saccomanno, S., Gatteschi, B., Pera, C., Aste, H., Ferrara, G. B., & Nicolò, G. (2001). Pancreatic intraductal sampling during ERCP in patients with chronic pancreatitis and pancreatic cancer: cytologic studies and k-ras-2 codon 12 molecular analysis in 47 cases. Gastrointestinal Endoscopy, 54(5), 595-9.
Pugliese V, et al. Pancreatic Intraductal Sampling During ERCP in Patients With Chronic Pancreatitis and Pancreatic Cancer: Cytologic Studies and K-ras-2 Codon 12 Molecular Analysis in 47 Cases. Gastrointest Endosc. 2001;54(5):595-9. PubMed PMID: 11677475.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pancreatic intraductal sampling during ERCP in patients with chronic pancreatitis and pancreatic cancer: cytologic studies and k-ras-2 codon 12 molecular analysis in 47 cases. AU - Pugliese,V, AU - Pujic,N, AU - Saccomanno,S, AU - Gatteschi,B, AU - Pera,C, AU - Aste,H, AU - Ferrara,G B, AU - Nicolò,G, PY - 2001/10/26/pubmed PY - 2002/1/5/medline PY - 2001/10/26/entrez SP - 595 EP - 9 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 54 IS - 5 N2 - BACKGROUND: A preoperative tissue diagnosis of pancreatic cancer is desirable but difficult to obtain. METHODS: Pancreatic brush cytology, salvage cytology, and collection of pancreatic juice were attempted prospectively during ERCP in 34 patients with pancreatic cancer and 11 with chronic pancreatitis. K-ras-2 codon 12 was analyzed for presence and type of point mutations. RESULTS: Brush cytology coupled with salvage cytology had a sensitivity of 74%. The addition of cytologic analysis of pancreatic juice did not substantially improve sensitivity (76%). K-ras-2 was mutated in both cancer (87%) and pancreatitis (40%). The specificity for cytology was 100% and for K-ras-2 mutations 60%. Combining cytology with mutation analysis increased sensitivity to 93% but reduced the positive predictive value. The negative predictive value never exceeded 75%. None of the patients with chronic pancreatitis had cancer develop (median follow-up 60 months). CONCLUSIONS: Pancreatic ductal brushing with salvage cytology is useful in the diagnosis of cancer, whereas cytologic analysis of pancreatic juice can be abandoned. At present, K-ras-2 mutation is not useful for differentiating pancreatic cancer from chronic pancreatitis or the identification of patients with chronic pancreatitis at risk for malignant transformation. SN - 0016-5107 UR - https://www.unboundmedicine.com/medline/citation/11677475/Pancreatic_intraductal_sampling_during_ERCP_in_patients_with_chronic_pancreatitis_and_pancreatic_cancer:_cytologic_studies_and_k_ras_2_codon_12_molecular_analysis_in_47_cases_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(01)70010-7 DB - PRIME DP - Unbound Medicine ER -