Targeted next-generation sequencing of FNA-derived DNA in pancreatic cancer.
To improve the diagnostic value of fine-needle aspiration (FNA)-derived material, we perform targeted next-generation sequencing (NGS) in patients with a suspect lesion of the pancreas. The NGS analysis can lead to a change in the treatment plan or supports inconclusive or uncertain cytology results. We describe the advantages of NGS using one particular patient with a recurrent pancreatic lesion 7 years after resection of a pancreatic ductal adenocarcinoma (PDAC). Our NGS analysis revealed the presence of a presumed second primary cancer in the pancreatic remnant, which led to a change in treatment: resection with curative intend instead of palliation. Additionally, NGS identified an unexpected germline CDKN2A 19-base pair deletion, which predisposed the patient to developing PDAC. Preoperative NGS analysis of FNA-derived DNA can help identify patients at risk for developing PDAC and define future therapeutic options.
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Babs G
BG
Sibinga Mulder
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
J Sven D
JS
Mieog
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Henricus J M
HJ
Handgraaf
Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
Arantza
A
Farina Sarasqueta
Department of Gastroenterology, Leiden University Medical Center, Leiden, The Netherlands.
Hans F A
HF
Vasen
Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands.
Thomas P
TP
Potjer
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Rutger-Jan
RJ
Swijnenburg
Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
Saskia A C
SA
Luelmo
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Shirin
S
Feshtali
Department of Gastroenterology, Leiden University Medical Center, Leiden, The Netherlands.
Akin
A
Inderson
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Alexander L
AL
Vahrmeijer
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Bert A
BA
Bonsing
Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
Tom
T
van Wezel
Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
Hans
H
Morreau
D044963:Biopsy, Fine-Needle; D021441:Carcinoma, Pancreatic Ductal / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D004247:DNA; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D017422:Sequence Analysis, DNA; D016896:Treatment Outcome
D004247:DNA
CANCER; DIAGNOSTICS; DNA; MOLECULAR PATHOLOGY; PANCREAS