Abstract
Abstract Introduction: Pancreatic cancer remains an incurable and rapidly lethal cancer, with a 5-year survival rate of less than 10%. Little to nothing is known about advanced pancreatic cancer because of problems with tissue availability and usually insufficient quantity of tissue available for diagnosis and study. One of the key features of genetic basis of PDAC is the point mutation of KRAS oncogene occurred in 95 % of its pathogenesis. Plec1 was also recently identified as PDAC specific biomarker. Aims and Methods: The aim of this study was to find out the techniques using minimal specimens in order to achieve accurate diagnosis of patients with suspected PDACs. DNA was extracted from EUS-guided FNA samples in 80 patients with suspected PDACs. Seven different somatic mutations of KRAS oncogene were evaluated using ARMS and Scorpions technology, and immunohistochemical staining of Plec1 antibody was done. Results: The total of 80 study patients with suspected of PDACs underwent EUS-guided FNA and the final diagnosis were as follows; PDAC: 63 patients, pancreas neuroendocrine tumor: 4, autoimmune pancreatitis: 3, chronic pancreatitis: 1, metastasis to pancreas: 6, others: 3. The sensitivity and specificity of pathologic diagnosis in EUS-guided FNA samples were 87% and 88% respectively. When we combine KRAS oncogene mutational analysis and pathologic reports of FNA samples, we could get the following sensitivities and specificities; 95% vs. 97%. Also, adding the results of plectin-1 antibodies of immunohistochemical staining could increase the sensitivity of PDAC diagnosis. Conclusion: Triple combinations of the techniques (pathologic reports, KRAS oncogene mutational analysis, Plec1 staining) could increase accuracy, however, cost-effectiveness and laborious work should be taken into consideration in clinical practice. Further investigation of using minimal specimens to study PDACs may enable us to understand biological behavior and to identify better tools for the diagnosis and treatment of this deadly cancer. Citation Information: Mol Cancer Ther 2013;12(11 Suppl):A39. Citation Format: Joo Kyung Park, Byung Jun Song, Ji Kon Ryu, Yong-Tae Kim, Se-Hoon Lee. Analysis of endoscopic ultrasound (EUS) - guided fine needle aspiration (FNA) samples from patients with suspected pancreatic ductal adenocarcinomas (PDACS) using plectin-1 (PLEC1) and KRAS oncogene mutation analysis. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr A39.
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