Advertisement
Gastrointestinal Endoscopy
Advanced searchSave search
Research Article|Articles in Press

Investigation into the content of red material in EUS-guided pancreatic cancer biopsies

  • Meng-Ying Lin
    Affiliations
    Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
    Search for articles by this author
  • Yung-Yeh Su
    Affiliations
    National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan

    Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
    Search for articles by this author
  • Yu-Ting Yu
    Affiliations
    Department of pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
    Search for articles by this author
  • Chien-Jui Huang
    Affiliations
    Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
    Search for articles by this author
  • Bor-Shyang Sheu
    Affiliations
    Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
    Search for articles by this author
  • Wei-Lun Chang
    Correspondence
    Correspondence to: Wei-Lun Chang, M.D., Ph.D, Department of Internal Medicine, National Cheng Kung University Hospital, No.138, Sheng Li Road, Tainan 704, Taiwan, Phone: +886-6-2353535 ext. 5368. FAX: +886-6-2766175,
    Affiliations
    Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
    Search for articles by this author
Published:January 27, 2023DOI:https://doi.org/10.1016/j.gie.2023.01.041
Investigation into the content of red material in EUS-guided pancreatic cancer biopsies
Previous ArticleSafety and Feasibility of Same-Day Discharge After Endoscopic Submucosal Dissection: A Western Multicenter Prospective Cohort Study
Next ArticleCold snare endoscopic mucosal resection for the removal of large duodenal adenomas
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Background and aims

      The red material occupying the larger portion of the acquired sample in EUS fine needle biopsy (FNB) is seldom investigated. We aimed to evaluate the composition of the red material.

      Methods

      Patients with a solid pancreatic mass who received EUS FNB from Sep. 2020 to Jun. 2021 were enrolled. The white and red materials were separated immediately after puncture. Needle passes proceeded until two specimens with more than 4 mm of white material were obtained. An extra needle pass was conducted for DNA collection. The DNA amount, KRAS mutation type and mutation allele frequency were compared between the white and red material.

      Results

      A total of 40 patients were enrolled with 68 paired white and red materials. The diagnostic accuracy was slightly higher in the white material (92.5% vs. 82.5%, p=0.219). On the histology slides, the area of the tumor gland was comparable in both materials, but the total tissue area was larger in the red material (9.74 & 10.74 mm2 larger by GLM &GEE, both p<0.001). The amount of DNA was significantly higher in the red material (2.99 μg [IQR 1.67-7.17] vs. 0.70 μg [IQR 0.30-1.19], p<0.001). Common pancreatic adenocarcinoma KRAS mutation was identified at a rate of 85% for the white material and 95% for the red material. Whether it was red or white material, there was a high concordance of KRAS mutation types (34/40, 85%) and high correlation of mutation allele frequency (ρ=0.66, p<0.001).

      Conclusions

      In EUS FNB, the red material contains a higher amount of tumor DNA, and can be an alternative source for tumor DNA analysis.

      Keywords

      Acronyms and Abbreviations:

      EUS (Endoscopic ultrasound), FNB (Fine needle biopsy), KRAS (Kirsten rat sarcoma virus), GLM (Generalized linear model), GEE (Generalized estimated equation), MOSE (Macroscopic on-site evaluation), NGS (Next-generation sequencing), PDAC (Pancreatic ductal adenocarcinoma), OCT (Optimal cutting temperature), PCR (Polymerase chain reaction), AIC (Akaike’s information criterion), QIC (Quasilikelihood under the independence model criterion), IQR (Interquartile range), SD (Standard deviation), PaIN (Pancreatic intraepithelial neoplasm)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Gastrointestinal Endoscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      Article info

      Publication history

      Accepted: January 22, 2023
      Received in revised form: December 22, 2022
      Received: April 29, 2022

      Publication stage

      In Press Journal Pre-Proof

      Footnotes

      Funding

      This study was funded by National Cheng Kung University Hospital (NCKUH-10909044) and the Ministry of Science and Technology (MOST 111-2320-B-006-054), Taiwan.

      Authorship

      All persons who meet authorship criteria are listed as authors, and all authors certify they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing, or revision of the manuscript. Furthermore, each author certifies this material or similar material has not been and will not be submitted to or published in any other publication. The detailed contributions are listed as below

      Dr. Meng-Ying Lin had equal contribution in conceptualization and led in data curation, formal analysis, investigation, and original draft writing. Dr. Yu-Ting Yu had the lead contribution in pathological review. Dr. Yung-Yeh Su, and Dr. Chien-Jui Huang had supporting roles in data curation. Professor Bor-Shyang Sheu made the lead contribution in resource support and supervision. Corresponding author, Dr. Wei-Lun Chang played the lead role in conceptualization, methodology, validation and review & editing final draft.

      Conflict of interest

      All authors declared no conflicts of interest.

      Acknowledgement

      We are grateful to Dr. Sheng-Hsiang Lin and Ms. Chih-Hui Hsu for providing the statistical consulting services from the Biostatistics Consulting Center, Clinical Medicine Research Center, National Cheng Kung University Hospital.

      Identification

      DOI: https://doi.org/10.1016/j.gie.2023.01.041

      Copyright

      © 2023 by the American Society for Gastrointestinal Endoscopy

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX