title: PDX-1 mRNA expression in endoscopic ultrasound-guided fine needle cytoaspirate: perspectives in the diagnosis of pancreatic cancer.
abstract: OBJECTIVE
  Endoscopic ultrasound-guided fine needle aspiration is routinely used in the diagnostic work up of pancreatic cancer but has a low sensitivity. Studies showed that Pancreatic Duodenal Homeobox-1 (PDX-1) is expressed in pancreatic cancer, which is associated with a worse prognosis. We aimed to verify whether the assessment of PDX-1 in endoscopic ultrasound-guided fine needle aspiration samples may be helpful for the diagnosis of pancreatic cancer.
  
  
  METHODS
  mRNA of 54 pancreatic cancer and 25 cystic lesions was extracted. PDX-1 expression was assessed by Real-Time PCR.
  
  
  RESULTS
  In all but two patients with pancreatic cancer, PDX-1 was expressed and was found positive in 7 patients with pancreatic cancer in which cytology was negative. The positivity was associated with a probability of 0.98 (95% CI 0.90-1.00) of having cancer and the negativity with one of 0.08 (95% CI 0.01-0.27). The probability of cancer rose to 1.00 (95% CI 0.97-1.00) for patients positive to both PDX-1 and cytology and fell to 0.0 (95% CI 0.00-0.15) in patients negative for both.
  
  
  CONCLUSIONS
  PDX-1mRNA is detectable in samples of pancreatic cancer. Its quantification may be helpful to improve the diagnosis of pancreatic cancer.
authors.affiliation: Clinic of Gastroenterology and Hepatology, Università Politecnica delle Marche, Ancona, Italy. Electronic address: m.marzioni@univpm.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Marzioni
authors.affiliation: Division of Gastroenterology, Azienda Ospedaliero Universitaria "Ospedali Riuniti", Ancona, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Germani
authors.affiliation: Clinic of Gastroenterology and Hepatology, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Agostinelli
authors.affiliation: Epidemiology Unit, Centro Studi Fegato, Trieste, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bedogni
authors.affiliation: Clinic of Gastroenterology and Hepatology, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Saccomanno
authors.affiliation: Division of Gastroenterology, Azienda Ospedaliero Universitaria "Ospedali Riuniti", Ancona, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Marini
authors.affiliation: Servizio di Gastroenterologia - Ospedale "Ramazzini" Carpi, Modena, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bellentani
authors.affiliation: Servizio di Gastroenterologia - Ospedale "Ramazzini" Carpi, Modena, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Barbera
authors.affiliation: Clinic of Gastroenterology and Hepatology, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Samuele
authors.initials: S
authors.lastname: De Minicis
authors.affiliation: Clinic of Gastroenterology and Hepatology, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Rychlicki
authors.affiliation: Institute of Pathologic Anatomy, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Santinelli
authors.affiliation: Division of Cytopathology, Azienda Ospedaliero Universitaria "Ospedali Riuniti", Ancona, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Ferretti
authors.affiliation: Servizio di Gastroenterologia - Ospedale "Ramazzini" Carpi, Modena, Italy.
authors.forename: Pier Vittorio
authors.initials: PV
authors.lastname: Di Maira
authors.affiliation: Clinic of Gastroenterology and Hepatology, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Gianluca Svegliati
authors.initials: GS
authors.lastname: Baroni
authors.affiliation: Clinic of Gastroenterology and Hepatology, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Benedetti
authors.affiliation: Division of Cytopathology, Azienda Ospedaliero Universitaria "Ospedali Riuniti", Ancona, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Caletti
authors.affiliation: Division of Gastroenterology, Azienda Ospedaliero Universitaria "Ospedali Riuniti", Ancona, Italy.
authors.forename: Ivano
authors.initials: I
authors.lastname: Lorenzini
authors.affiliation: Division of Gastroenterology and Digestive Endoscopy, Università degli Studi di Bologna, Castel San Pietro Terme Hospital, Castel San Pietro Terme, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Fusaroli
mesh_terms: D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000235:genetics*; D016022:Case-Control Studies; D018282:Cystadenocarcinoma, Mucinous / Q000175:diagnosis / Q000235:genetics*; D018284:Cystadenocarcinoma, Serous / Q000175:diagnosis / Q000235:genetics*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D018398:Homeodomain Proteins / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000235:genetics*; D010192:Pancreatic Pseudocyst / Q000175:diagnosis; D050500:Pancreatitis, Chronic / Q000175:diagnosis; D012333:RNA, Messenger / Q000378:metabolism*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015534:Trans-Activators / Q000235:genetics*
chemical_list: D018398:Homeodomain Proteins; D012333:RNA, Messenger; D015534:Trans-Activators; C084010:pancreatic and duodenal homeobox 1 protein
keywords: EUS; FNA; PDX-1; Pancreatic cancer; Sensitivity; Specificity