title: Quantitative analysis of NPTX2 hypermethylation is a promising molecular diagnostic marker for pancreatic cancer.
abstract: OBJECTIVE
  Percutaneous fine-needle aspiration cytology or biopsy has been used for pathological confirmation in pancreatic cancer. Sometimes, it is difficult to approach the mass because of surrounding major vessels, and there is a risk of seeding. Although endoscopic retrograde cholangiopancreatography (ERCP)-guided pancreatic duct brush cytology is less invasive, its reliability is very low. Recently, aberrantly methylated genes were reported in pancreatic cancer tissue. This study was to develop a novel molecular diagnostic approach based on epigenetic characteristics.
  
  
  METHODS
  We enrolled pathologically proven 33 pancreatic cancer patients and 22 benign pancreaticobiliary disease patients. The ERCP-guided pancreatic duct brush cytology samples were obtained. Genomic DNA was extracted, and NPTX2 CpG island hypermethylation was examined quantitatively by real-time polymerase chain reaction amplification after chemical modification.
  
  
  RESULTS
  Pancreatic cancer cytology samples had statistically significant higher levels of NPTX2 methylation compared with benign diseases, and the optimal cutoff value of NPTX2 methylation was 1.2%. The sensitivity was 87%, and specificity was 80%, whereas pathological examination by ERCP-guided pancreatic duct brush cytology had a sensitivity of 38%.
  
  
  CONCLUSIONS
  The quantitative analysis of NPTX2 hypermethylation may play a role in making highly sensitive and less invasive diagnosis of pancreatic cancer. Therefore, NPTX2 hypermethylation could be a promising molecular diagnostic marker.
authors: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors: Joo Kyung
authors: JK
authors: Park
authors: Ji Kon
authors: JK
authors: Ryu
authors: Kwang Hyuk
authors: KH
authors: Lee
authors: Jun Kyu
authors: JK
authors: Lee
authors: Won Jae
authors: WJ
authors: Yoon
authors: Sang Hyub
authors: SH
authors: Lee
authors: Ji Won
authors: JW
authors: Yoo
authors: Sang Myung
authors: SM
authors: Woo
authors: Gyung Yub
authors: GY
authors: Lee
authors: Cheol Ho
authors: CH
authors: Lee
authors: Yong-Tae
authors: YT
authors: Kim
authors: Yong Bum
authors: YB
authors: Yoon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D002097:C-Reactive Protein / Q000235:genetics*; D021441:Carcinoma, Pancreatic Ductal / Q000737:chemistry / Q000175:diagnosis*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003199:Computer Systems; D018899:CpG Islands; D019175:DNA Methylation; D004273:DNA, Neoplasm / Q000032:analysis* / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000235:genetics*; D009419:Nerve Tissue Proteins / Q000235:genetics*; D010182:Pancreatic Diseases / Q000175:diagnosis / Q000378:metabolism; D010190:Pancreatic Neoplasms / Q000737:chemistry / Q000175:diagnosis*; D016133:Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D000099153:Pentraxins
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein; D004273:DNA, Neoplasm; D009363:Neoplasm Proteins; D009419:Nerve Tissue Proteins; D000099153:Pentraxins