Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa Prefecture, Takamatsu 761-0793, Japan.
Gastroenterol Res Pract. 2012;2012:243524. doi: 10.1155/2012/243524. Epub 2012 Nov 8.
We review the utility of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), a rapid, safe, cost-effective, and accurate diagnostic modality for evaluating pancreatic tumors. EUS-FNA is currently used for the diagnosis and staging of pancreatic tumors. The sensitivity of EUS-FNA for pancreatic malignancy ranges from 75% to 94%, and its specificity approaches 100% in most studies. However, EUS-FNA has some limitations in the diagnosis of well-differentiated or early-stage cancers. Recent evidence suggests that molecular biological analysis using specimens obtained by EUS-FNA improves diagnostic sensitivity and specificity, especially in borderline cytological cases. It was also reported that additional information regarding patient response to chemotherapy, surgical resectability, time to metastasis, and overall survival was acquired from the genetic analysis of specimens obtained by EUS-FNA. Other studies have revealed that the analysis of KRAS, MUC, p53, p16, S100P, SMAD4, and microRNAs is helpful in making the diagnosis of pancreatic carcinoma. In this paper, we describe the present state of genetic diagnostic techniques for use with EUS-FNA samples in pancreatic diseases. We also discuss the role of molecular biological analyses for the diagnosis of pancreatic carcinoma.
我们回顾了内镜超声引导下细针抽吸（EUS-FNA）的实用性，EUS-FNA 是一种快速、安全、具有成本效益且准确的诊断胰腺肿瘤的方法。EUS-FNA 目前用于胰腺肿瘤的诊断和分期。在大多数研究中，EUS-FNA 对胰腺恶性肿瘤的敏感性为 75%至 94%，特异性接近 100%。然而，EUS-FNA 在诊断分化良好或早期癌症方面存在一些局限性。最近的证据表明，使用 EUS-FNA 获得的标本进行分子生物学分析可提高诊断的敏感性和特异性，尤其是在临界细胞学病例中。据报道，还从 EUS-FNA 获得的标本的基因分析中获得了有关患者对化疗的反应、手术可切除性、转移时间和总体生存率的其他信息。其他研究表明，KRAS、MUC、p53、p16、S100P、SMAD4 和 microRNAs 的分析有助于诊断胰腺癌。在本文中，我们描述了用于胰腺疾病的 EUS-FNA 样本的遗传诊断技术的现状。我们还讨论了分子生物学分析在诊断胰腺癌中的作用。
