Abstract
We review the utility of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), a rapid, safe, cost-effective, and accurate diagnostic modality for evaluating pancreatic tumors. EUS-FNA is currently used for the diagnosis and staging of pancreatic tumors. The sensitivity of EUS-FNA for pancreatic malignancy ranges from 75% to 94%, and its specificity approaches 100% in most studies. However, EUS-FNA has some limitations in the diagnosis of well-differentiated or early-stage cancers. Recent evidence suggests that molecular biological analysis using specimens obtained by EUS-FNA improves diagnostic sensitivity and specificity, especially in borderline cytological cases. It was also reported that additional information regarding patient response to chemotherapy, surgical resectability, time to metastasis, and overall survival was acquired from the genetic analysis of specimens obtained by EUS-FNA. Other studies have revealed that the analysis of KRAS, MUC, p53, p16, S100P, SMAD4, and microRNAs is helpful in making the diagnosis of pancreatic carcinoma. In this paper, we describe the present state of genetic diagnostic techniques for use with EUS-FNA samples in pancreatic diseases. We also discuss the role of molecular biological analyses for the diagnosis of pancreatic carcinoma.
Highlights
Pancreatic cancer is the fifth-leading cause of cancerrelated death in Japan, and the annual mortality due to pancreatic cancer is estimated to be over 20,000 individuals
We describe the current state of the genetic diagnosis techniques, and we discuss the role of molecular biological analyses for the diagnosis of pancreatic carcinoma
These results suggest that the use of S100P in the molecular diagnosis of pancreatic adenocarcinoma using Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) can increase the diagnostic accuracy for pancreatic cancer
Summary
Pancreatic cancer is the fifth-leading cause of cancerrelated death in Japan, and the annual mortality due to pancreatic cancer is estimated to be over 20,000 individuals. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) was introduced into clinical practice in the early 1990s, and it is considered one of the most useful methods for histological diagnosis and staging of pancreatic cancers [1, 2]. EUS-FNA of the pancreas is an efficient and minimally invasive procedure for the diagnosis and staging of pancreatic cancer. It is important to determine the histological subtype of the tumor, especially in an unresectable tumor because the choice of treatment largely depends on the subtype [1]. It is necessary to improve the diagnostic sensitivity and specificity of EUS-FNA. We describe the current state of the genetic diagnosis techniques, and we discuss the role of molecular biological analyses for the diagnosis of pancreatic carcinoma
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