STUART ASTBURY STUART.ASTBURY@NOTTINGHAM.AC.UK
Research Fellow
Next-generation sequencing of pancreatic cyst wall specimens obtained using Moray micro-forceps for improving diagnostic accuracy
Astbury, Stuart; Baskar, Aishwarya; Grove, Jane I; Kaye, Philip; Aravinthan, Aloysious D; James, Martin W; Clarke, Christopher; Aithal, Guruprasad P; Venkatachalapathy, Suresh Vasan
Authors
Aishwarya Baskar
JANE GROVE jane.grove@nottingham.ac.uk
Assistant Professor
Philip Kaye
ALOYSIOUS ARAVINTHAN ALOYSIOUS.ARAVINTHAN@NOTTINGHAM.AC.UK
Clinical Associate Professor
Martin W James
Christopher Clarke
GURUPRASAD AITHAL Guru.Aithal@nottingham.ac.uk
Professor of Hepatology
Suresh Vasan Venkatachalapathy
Abstract
Background and study aims Pancreatic cysts are common incidental findings, with an estimated prevalence of 13-15% in imaging done for other reasons. It is difficult to identify cysts with malignant potential. Diagnosis often relies on collection of cyst fluid, but tissue sampling using micro-forceps may allow for a more reliable diagnosis and higher yield of DNA for next-generation sequencing (NGS).
Patients and methods 24 patients referred for endoscopic ultrasound were recruited. Biopsies were taken using micro-forceps and the AmpliSeq Cancer Hotspot panel was used for NGS, a PCR assay targeting several hotspots within 50 genes, including GNAS, KRAS and VHL.
Results The concentration of DNA extracted from 24 cyst wall samples was significantly higher than in the 9/24 available matched cyst fluid samples. Cyst wall biopsy was able to diagnose 19/24 cysts (5 high risk, 6 intraductal papillary mucinous neoplasm and 4 benign). The sensitivity, specificity and diagnostic accuracy for standard of care was 66.6%, 50% and 63.1% respectively and for standard of care with NGS was 100%, 50% and 89.4% respectively.
Conclusions Cyst wall biopsy performs well in diagnosing cysts but was inadequate in 5/24 patients. NGS data correlates well with histology and may aid in diagnosis and risk stratification of pancreatic cysts.
Deposit Date | Sep 12, 2023 |
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Publicly Available Date | Sep 14, 2023 |
Public URL | https://nottingham-repository.worktribe.com/output/17947157 |
Publisher URL | https://www.medrxiv.org/content/10.1101/2023.02.23.23286230v1 |
Additional Information | This article is a preprint and has not been peer-reviewed. |
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Next-generation sequencing of pancreatic cyst wall specimens obtained using Moray micro-forceps for improving diagnostic accuracy
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https://creativecommons.org/licenses/by/4.0/
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