Analysis of circulating cell-free DNA after endoscopic ultrasound-guided fine needle aspiration in pancreatic ductal adenocarcinoma |
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| Affiliation: | 1. Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan;2. Department of Gastroenterology, Yamanashi Central Hospital, Yamanashi, Japan;3. Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan;1. Cedars Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA, USA;2. Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA;3. Center for Research on Healthcare Data Center, University of Pittsburgh, Pittsburgh, PA, USA;4. Mercy Clinic Gastroenterology, St. Louis, MO, USA;5. Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;6. Aurora St. Luke''s Medical Center, Milwaukee, WI, USA;7. Gastroenterology Associates, Richmond, VA, USA;8. Pancreatitis Center, Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD, USA;9. Division of Gastroenterology and Hepatology, University of Alabama Birmingham, AL, USA;10. Gastro Health, Baptist Health, Miami, FL, USA;1. Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China;2. Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, 730030, China;1. Dept. of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India;2. Wellcome-DBT Indian Alliance Labs., Institute of Basic and Translational Research, Asian Healthcare Foundation, Hyderabad, India;3. Dept. of General Medicine, Sapporo Medical University, Japan;4. Dept. of Surgical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India;1. Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, MN, 55455, USA;2. Department of Radiology, University of Minnesota, Minneapolis, MN, 55455, USA;3. Saint Louis University Center for Outcomes Research, St Louis, MO, USA;1. Medical Doctor, Erzincan University, Department of Radiology, Erzincan, Turkey;2. Associate Professor, Erzincan University, Department of Radiology, Erzincan, Turkey;3. Professor, Erzincan University, Department of Radiology, Erzincan, Turkey;4. Professor, Erzurum Ataturk University, Department of Radiology, Erzurum, Turkey;1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea;2. Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea;3. Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, South Korea;4. Department of Internal Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, South Korea |
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| Abstract: | Background/ObjectivesRecently, increase in cell-free DNA (cfDNA) concentration or newly detected KRAS mutation after endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) biopsy were reported to be related to the occurrence of new distant metastasis. In this study, we investigated whether cfDNA concentration increased with the release of tumor components into the blood after EUS-FNA and whether its increase was related to prognosis.MethodsSixty-eight patients underwent EUS-FNA and were pathologically confirmed as having pancreatic ductal adenocarcinoma (PDAC). We measured plasma cfDNA concentration and the copy number of KRAS mutation in 68 patients and circulating tumor cells in 8 before and after EUS-FNA.ResultsThe average cfDNA concentration after EUS-FNA (672.5 ± 919.6 ng/mL) was significantly higher than that before EUS-FNA (527.7 ± 827.3 ng/mL) (P < 0.001). KRAS mutation in plasma was detected in 8 patients (11.8%), however a significant increase in cfDNA concentration after EUS-FNA was not related to the change in KRAS-mutant copy number. Minimal increase in circulating tumor cells was observed in 3 of 8 patients. New distant metastasis was observed within 286 days to initial metastasis detection in 6 of 12 patients with ≥2-fold increase in cfDNA concentration and 26 of 56 patients with <2-fold increase within 185 days. In 32 patients who underwent surgery, ≥2-fold increase in cfDNA did not affect early recurrence.ConclusionsThe increase in cfDNA concentration after EUS-FNA was not caused by tumor cell components released into blood vessels. Hence, the risk of seeding via the blood stream after EUS-FNA may need not be considered. |
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| Keywords: | Cell-free nucleic acids Circulating neoplastic cells Endoscopic ultrasound-guided fine needle aspiration Pancreatic ductal carcinoma |
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