Sa2041 Predictors of Lymph Nodal Metastases With Resectable Pancreatic Adenocarcinoma

Abstract

Background: Pancreatic ductal adenocarcinoma (PDAC) is frequently diagnosed at an advanced stage. Breath testing is a non-invasive method that detects volatile organic compounds (VOCs). The aim was to identify VOCs that discriminate patients with PDAC from those with chronic pancreatitis (CP) and healthy controls. Methods: Blood was obtained from healthy controls (screening colonoscopy), severe CP (SCP, imaging demonstrating pancreatic calcifications), minimal change CP (MCCP, ≥4 standard endoscopic ultrasound (EUS) criteria and endoscopic pancreatic function testing peak bicarbonate <80 mEq), and PDAC (positive cytology obtained by EUS guided fine needle aspiration).Twenty milliliters of headspace was removed from the samples and analyzed for 22 VOCs by selected ion flow tube mass spectrometry. Analysis of variance was used to assess differences in VOC levels and receiver operating characteristic (ROC) analysis was performed to assess the role of VOCs in distinguishing PDAC from severe CP, MCCP and healthy controls. Results: 73 patients were included (20 healthy controls, 19 MCCP, 18 SCP and 16 PDAC). Adjusting for tobacco and alcohol usage, acetonitrile, ethanol, isoprene, 1-heptene, ammonia, ethane and triethyl amine were found to be associated with PDAC compared to all groups. ROC