title: Role of endoscopic ultrasound in the molecular diagnosis of pancreatic cancer.
abstract: Pancreatic ductal adenocarcinoma remains one of the most deadly types of tumor. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a safe, cost-effective, and accurate technique for evaluating and staging pancreatic tumors. However, EUS-FNA may be inconclusive or doubtful in up to 20% of cases. This review underlines the clinical interest of the molecular analysis of samples obtained by EUS-FNA in assessing diagnosis or prognosis of pancreatic cancer, especially in locally advanced tumors. On EUS-FNA materials DNA, mRNA and miRNA can be extracted, amplified, quantified and subjected to methylation assay. Kras mutation assay, improves diagnosis of pancreatic cancer. When facing to clinical and radiological presentations of pseudo-tumorous chronic pancreatitis, wild-type Kras is evocative of benignity. Conversely, in front of a pancreatic mass suspected of malignancy, a mutated Kras is highly evocative of pancreatic adenocarcinoma. This strategy can reduce false-negative diagnoses, avoids the delay of making decisions and reduces loss of surgical resectability. Similar approaches are conducted using analysis of miRNA expression as well as Mucin or markers of invasion (S100P, S100A6, PLAT or PLAU). Beyond the diagnosis approach, the prediction of response to treatment can be also investigated form biomarkers expression within EUS-FNA materials.
authors.affiliation: Barbara Bournet, Louis Buscail, Department of Gastroenterology, CHU Toulouse Rangueil, University of Toulouse, 31059 Toulouse, France.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bournet
authors.affiliation: Barbara Bournet, Louis Buscail, Department of Gastroenterology, CHU Toulouse Rangueil, University of Toulouse, 31059 Toulouse, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Gayral
authors.affiliation: Barbara Bournet, Louis Buscail, Department of Gastroenterology, CHU Toulouse Rangueil, University of Toulouse, 31059 Toulouse, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Torrisani
authors.affiliation: Barbara Bournet, Louis Buscail, Department of Gastroenterology, CHU Toulouse Rangueil, University of Toulouse, 31059 Toulouse, France.
authors.forename: Janick
authors.initials: J
authors.lastname: Selves
authors.affiliation: Barbara Bournet, Louis Buscail, Department of Gastroenterology, CHU Toulouse Rangueil, University of Toulouse, 31059 Toulouse, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Cordelier
authors.affiliation: Barbara Bournet, Louis Buscail, Department of Gastroenterology, CHU Toulouse Rangueil, University of Toulouse, 31059 Toulouse, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Buscail
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics; D021441:Carcinoma, Pancreatic Ductal / Q000737:chemistry / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000628:therapy; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D006801:Humans; D035683:MicroRNAs / Q000032:analysis; D025202:Molecular Diagnostic Techniques; D009077:Mucins / Q000032:analysis; D010190:Pancreatic Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000628:therapy; D011237:Predictive Value of Tests; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D035683:MicroRNAs; D009077:Mucins
keywords: Chronic pancreatitis; Endoscopic ultrasound-guided fine-needle aspiration; KRAS-mutation assay; Micro-RNA; Pancreatic ductal adenocarcinoma; Solid pancreatic mass; qPCR analysis