Comprehensive review on endoscopic ultrasound-guided tissue acquisition techniques for solid pancreatic tumor

Masuda, Sakue; Koizumi, Kazuya; Shionoya, Kento; Jinushi, Ryuhei; Makazu, Makomo; Nishino, Takashi; Kimura, Karen; Sumida, Chihiro; Kubota, Jun; Ichita, Chikamasa; Sasaki, Akira; Kobayashi, Masahiro; Kako, Makoto; Uojima, Haruki

doi:10.3748/wjg.v29.i12.1863

Cited by 12 publications

(7 citation statements)

References 76 publications

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“…In PDAC, precision medicine is rapidly evolving, and in the era of next-generation sequencing (NGS), in which a relatively limited amount of tissue sample can be successfully analyzed for the detection of genetic alterations, EUS TA plays a major role. Such actionable molecular changes can be seen in about one-fourth of PDAC which can be targeted with precision medicine [ 129 ]. The detection of actionable molecular alterations has led to the development of various drugs acting on one or multiple molecular pathways, like the KRAS and DNA mismatch repair (MMR) pathway, and studies have shown better overall survival when patients are treated with matched therapy ( n = 143; 2.58 years vs. 1.51 years; hazard ratio (HR) of 0.42 (95%CI: 0.26–0.68), p < 0.001) [ 130 ].…”

Section: Recent Advancement In Eus Ta In Pancreatic Carcinomamentioning

confidence: 99%

Role of Endoscopic Ultrasound in Diagnosis of Pancreatic Ductal Adenocarcinoma

Chatterjee,

Shah

2023

Diagnostics

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Pancreatic ductal adenocarcinoma (PDAC) is the most common (90%) type of solid pancreatic neoplasm. Due to its late presentation and poor survival rate, early diagnosis and timely treatment is of utmost importance for better clinical outcomes. Endoscopic ultrasound provides high-resolution images of the pancreas and has excellent sensitivity in the diagnosis of even small (<2 cm) pancreatic lesions. Apart from imaging, it also has an advantage of tissue acquisition (EUS fine-needle aspiration, FNA; or fine-needle biopsy, FNB) for definitive diagnoses. EUS-guided tissue acquisition plays a crucial role in genomic and molecular studies, which in today’s era of personalized medicine, are likely to become important components of PDAC management. With the use of better needle designs and technical advancements, EUS has now become an indispensable tool in the management of PDAC. Lastly, artificial intelligence for the detection of pancreatic lesions and newer automated needles for tissue acquisition will obviate observer dependency in the near future, resulting in the wider dissemination and adoption of this technology for improved outcomes in patients with PDAC.

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Section: Recent Advancement In Eus Ta In Pancreatic Carcinomamentioning

confidence: 99%

Role of Endoscopic Ultrasound in Diagnosis of Pancreatic Ductal Adenocarcinoma

Chatterjee,

Shah

2023

Diagnostics

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“…Endoscopic ultrasound-guided fine-needle tissue acquisition (EUS-TA) is recommended for the pathological diagnosis of mass lesions in the pancreas and used for the pathological diagnosis of PACC ( 68–70 ). EUS-TA is generally successful in obtaining tissue for diagnosis, and the incidence of adverse events is low in patients with pancreatic tumours ( 71 , 72 ). Because genetic analysis using histological specimens is needed in patients with unresectable pancreatic cancer, including PACC, large-gauge biopsy needles should be used, and multiple biopsy specimens should be obtained ( 73–77 ).…”

Section: Epidemiology Clinical Features Diagnosis Molecular Features ...mentioning

confidence: 99%

Comprehensive review of pancreatic acinar cell carcinoma: epidemiology, diagnosis, molecular features and treatment

Ikezawa,

Urabe,

Kai

et al. 2023

Japanese Journal of Clinical Oncology

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Pancreatic acinar cell carcinoma is a rare form (0.2–4.3%) of pancreatic neoplasm with unique clinical and molecular characteristics, which largely differ from pancreatic ductal adenocarcinoma. Pancreatic acinar cell carcinoma occurs more frequently in males and can occur in children. Serum lipase is elevated in 24–58% of patients with pancreatic acinar cell carcinoma. Pancreatic acinar cell carcinomas tend to be large at diagnosis (median tumour size: ~5 cm) and are frequently located in the pancreas head. Radiologically, pancreatic acinar cell carcinoma generally exhibits a solid appearance; however, necrosis, cystic changes and intratumoral haemorrhage can occur in larger lesions. Immunostaining is essential for the definitive diagnosis of pancreatic acinar cell carcinoma. Compared with pancreatic ductal adenocarcinoma, pancreatic acinar cell carcinoma has a more favourable prognosis. Although radical surgery is recommended for patients with pancreatic acinar cell carcinoma who do not have distant metastases, the recurrence rate is high. The effectiveness of adjuvant therapy for pancreatic acinar cell carcinoma is unclear. The response to FOLFIRINOX is generally favourable, and some patients achieve a complete response. Pancreatic acinar cell carcinoma has a different genomic profile compared with pancreatic ductal adenocarcinoma. Although genomic analyses have shown that pancreatic acinar cell carcinoma rarely has KRAS, TP53 and CDKN2A mutations, it has a higher prevalence of homologous recombination-related genes, including BRCA1/2 and ATM, than pancreatic ductal adenocarcinoma, suggesting high sensitivity to platinum-containing regimens and PARP inhibitors. Targeted therapies for genomic alternations are beneficial. Therefore, genetic testing is important for patients with pancreatic acinar cell carcinoma to choose the optimal therapeutic strategy.

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“…6,7 Endoscopic ultrasound-guided tissue acquisition (EUS-TA) via fine-needle aspiration (FNA) or fine-needle biopsy (FNB) is the primary sampling method for diagnosing solid pancreatic lesions. [8][9][10][11] For patients with pancreatic cancer, the role of EUS-TA has expanded from pathological diagnosis to obtaining adequate samples for molecular testing before initiating targeted therapies. [12][13][14] The current National Comprehensive Cancer Network guidelines recommend the consideration of germline testing, gene profiling, and mismatch repair/microsatellite instability testing for metastatic pancreatic ductal cancer.…”

Section: Introductionmentioning

confidence: 99%

Oil blotting paper for formalin fixation increases endoscopic ultrasound‐guided tissue acquisition‐collected sample volumes on glass slides

Yamai,

Ikezawa,

Seiki

et al. 2024

Cancer Medicine

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ObjectivesEndoscopic ultrasound‐guided tissue acquisition (EUS‐TA) is used for pathological diagnosis and obtaining samples for molecular testing, facilitating the initiation of targeted therapies in patients with pancreatic cancer. However, samples obtained via EUS‐TA are often insufficient, requiring more efforts to improve sampling adequacy for molecular testing. Therefore, this study investigated the use of oil blotting paper for formalin fixation of samples obtained via EUS‐TA.MethodsThis prospective study enrolled 42 patients who underwent EUS‐TA for pancreatic cancer between September 2020 and February 2022 at the Osaka International Cancer Institute. After a portion of each sample obtained via EUS‐TA was separated for routine histological evaluation, the residual samples were divided into filter paper and oil blotting paper groups for analysis. Accordingly, filter paper and oil blotting paper were used for the formalin fixation process. The total tissue, nuclear, and cytoplasm areas of each sample were quantitatively evaluated using virtual slides, and the specimen volume and histological diagnosis of each sample were evaluated by an expert pathologist.ResultsAll cases were cytologically diagnosed as adenocarcinoma. The area ratios of the total tissue, nuclear, and cytoplasmic portions were significantly larger in the oil blotting paper group than in the filter paper group. The frequency of cases with large amount of tumor cells was significantly higher in the oil blotting paper group (33.3%) than in the filter paper group (11.9%) (p = 0.035).ConclusionsOil blotting paper can increase the sample volume obtained via EUS‐TA on glass slides and improve sampling adequacy for molecular testing.

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Comprehensive review on endoscopic ultrasound-guided tissue acquisition techniques for solid pancreatic tumor

Cited by 12 publications

References 76 publications

Role of Endoscopic Ultrasound in Diagnosis of Pancreatic Ductal Adenocarcinoma

Role of Endoscopic Ultrasound in Diagnosis of Pancreatic Ductal Adenocarcinoma

Comprehensive review of pancreatic acinar cell carcinoma: epidemiology, diagnosis, molecular features and treatment

Oil blotting paper for formalin fixation increases endoscopic ultrasound‐guided tissue acquisition‐collected sample volumes on glass slides

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