Buchholz Malte, Kestler Hans A, Bauer Andrea, Böck Wolfgang, Rau Bettina, Leder Gerhard, Kratzer Wolfgang, Bommer Martin, Scarpa Aldo, Schilling Martin K, Adler Guido, Hoheisel Jörg D, Gress Thomas M
Department of Internal Medicine I, University of Ulm, Ulm, Germany.
Clin Cancer Res. 2005 Nov 15;11(22):8048-54. doi: 10.1158/1078-0432.CCR-05-1274.
Malignant tumors of the pancreas are frequently indistinguishable from inflammatory tumors arising in the context of a chronic pancreatitis with the use of conventional imaging techniques. Thus, cytologic analysis of cells obtained by abdominal ultrasound, computed tomography, or endoscopic ultrasound-guided fine needle aspiration biopsy is required for diagnosis. However, the reliability of cytologic analyses of pancreatic fine needle aspirates remains unsatisfactory, with a diagnostic accuracy of < or =80%. The purpose of the current study was therefore to develop a novel diagnostic approach based on expression profiling of biopsy material using a specialized diagnostic cDNA array.
Previous gene expression profiling studies were reevaluated to design a 558-feature diagnostic array. Minimal amounts of residual material from pancreatic cytology samples as well as surgically resected tumor and control tissue specimens were analyzed using the diagnostic array and a newly developed statistical classification system.
Our diagnostic approach resulted in 95% accurate differentiation between ductal adenocarcinomas and nonmalignant tumors of the pancreas. The diagnostic array, in conjunction with conventional diagnostic procedures, is thus suitable to significantly improve the reliability of pancreatic cancer diagnostics and can be expected to become a valuable new tool in the routine workup of suspect masses in the pancreas.
在使用传统成像技术时，胰腺恶性肿瘤常常难以与慢性胰腺炎背景下产生的炎性肿瘤区分开来。因此，需要对通过腹部超声、计算机断层扫描或内镜超声引导下细针穿刺活检获取的细胞进行细胞学分析以进行诊断。然而，胰腺细针穿刺抽吸物的细胞学分析可靠性仍不尽人意，诊断准确率≤80%。因此，本研究的目的是基于使用专门的诊断性cDNA阵列对活检材料进行表达谱分析，开发一种新的诊断方法。
重新评估先前的基因表达谱研究以设计一个有558个特征的诊断阵列。使用该诊断阵列和新开发的统计分类系统，对胰腺细胞学样本以及手术切除的肿瘤和对照组织标本中极少量的残留材料进行分析。
我们的诊断方法在区分胰腺导管腺癌和非恶性肿瘤方面准确率达到95%。因此，该诊断阵列与传统诊断程序相结合，适合显著提高胰腺癌诊断的可靠性，有望成为胰腺可疑肿块常规检查中的一种有价值的新工具。
