Tu1959 Potential Role of EZH2 Expression in Pancreatic Adenocarcinoma Cells

Abstract

G A A b st ra ct s screening via CT or MRI with EUS. Follow-up was recommended at 12 month intervals unless an abnormality warranted repeat screening at an earlier interval. All patients who presented for initial screening evaluation but failed to proceed to imaging evaluation tests were excluded. Results: There were 107 in the final cohort [Median Age 53 (29-84); 73 F (68.2%)] with follow-up of 0-109 months. There were 9 BRCA1 (3 with ≥1 first degree relative PC family history (FDR), 3 ≥1 second degree PC family history (SDR) and 3 with no PC family history). There were 27 BRCA2 (7 with ≥1 FDR, 3 with ≥1 SDR, 15 with no family history of PC); 2 HNPCC (1 ≥1 FDR and 1 ≥1 SDR), 4 Peutz-Jeghers with no PC family history, 26 Familial PC (≥2 FDR), 57 with PC family history not meeting Familial PC requirements. There were 19 (17.8%) initially screened via CT/MRI/EUS, 41 (38.3%) with CT/EUS, 5 (4.7%) with MRI/EUS, 27 (25.2%) with CT only , 5 (4.7%) with MRI only, and 8 (7.5%) with EUS only. The overall lesion detection accuracy for CT, MRI, and EUS were 20.0%, 18.8%, 34.2%. EUS was more accurate than MRI or CT at detecting cystic masses (EUS 23.3%, MRI 10.0%, CT 10.0%), side branch dilations (EUS 4.1%, MRI 0.0%, CT 0.0% ), parenchymal abnormalities (EUS 15.1%,MRI 6.3%, CT 1.1% ), and PD abnormalities (EUS 4.1%, MRI 0.0%, CT 1.1% ). Patients that had positive screening had a higher median age (57 vs 49), smoking history (30.6 vs 16.9%), and alcohol usage (50 vs 35.2%) than patients without abnormalities. Among HRI subgroups, more patients with initial pancreatic abnormalities on screening came from the Familial PC group (38.9 vs 16.9%). On the first follow-up imaging examination, EUS had greater accuracy at detecting all lesion types compared to MRI and CT (EUS 31.8%, MRI 8.0%, CT 4.3%), and all lesion sub-types that included cystic masses (EUS 18.2%, MRI 8.0%, CT 4.3%), side branch dilations (EUS 10.4%, MRI 0%, CT 0%), PD abnormalities (EUS 10.4%, MRI 0%, CT 0%), and other lesions (EUS 10.4%, MRI 0%, CT 0%). With regards to HRI characteristics, they also tended to be from the Familial PC HRI subgroup than other HRI groups (36.3% vs 28.8%). Conclusion: EUS appears to have a higher diagnostic yield compared to CT and MRI at detecting cystic masses, side branch dilations, parenchymal and PD abnormalities on initial screening and all pancreatic abnormalities on follow-up.