Specialized DNA arrays for the differentiation of pancreatic tumors.
OBJECTIVE
Malignant tumors of the pancreas are frequently indistinguishable from inflammatory tumors arising in the context of a chronic pancreatitis with the use of conventional imaging techniques. Thus, cytologic analysis of cells obtained by abdominal ultrasound, computed tomography, or endoscopic ultrasound-guided fine needle aspiration biopsy is required for diagnosis. However, the reliability of cytologic analyses of pancreatic fine needle aspirates remains unsatisfactory, with a diagnostic accuracy of < or =80%. The purpose of the current study was therefore to develop a novel diagnostic approach based on expression profiling of biopsy material using a specialized diagnostic cDNA array.


METHODS
Previous gene expression profiling studies were reevaluated to design a 558-feature diagnostic array. Minimal amounts of residual material from pancreatic cytology samples as well as surgically resected tumor and control tissue specimens were analyzed using the diagnostic array and a newly developed statistical classification system.


CONCLUSIONS
Our diagnostic approach resulted in 95% accurate differentiation between ductal adenocarcinomas and nonmalignant tumors of the pancreas. The diagnostic array, in conjunction with conventional diagnostic procedures, is thus suitable to significantly improve the reliability of pancreatic cancer diagnostics and can be expected to become a valuable new tool in the routine workup of suspect masses in the pancreas.
Buchholz
Malte
M
Department of Internal Medicine I, University of Ulm, Ulm, Germany.
Kestler
Hans A
HA
Bauer
Andrea
A
Böck
Wolfgang
W
Rau
Bettina
B
Leder
Gerhard
G
Kratzer
Wolfgang
W
Bommer
Martin
M
Scarpa
Aldo
A
Schilling
Martin K
MK
Adler
Guido
G
Hoheisel
Jörg D
JD
Gress
Thomas M
TM
D000230:Adenocarcinoma / Q000175:diagnosis / Q000235:genetics*; D000465:Algorithms; D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D006801:Humans; D020411:Oligonucleotide Array Sequence Analysis / Q000379:methods*; D010179:Pancreas / Q000378:metabolism / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000235:genetics*; D012334:RNA, Neoplasm / Q000235:genetics / Q000302:isolation & purification; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D012334:RNA, Neoplasm