The role of K-ras gene mutation analysis in EUS-guided FNA cytology specimens for the differential diagnosis of pancreatic solid masses: a meta-analysis of prospective studies

Diagnosis of pancreatic lesions collected by endoscopic ultrasound-guided fine-needle aspiration using next-generation sequencing

“…Therefore, the use of Sanger sequencing for PDAC is difficult due to possible contamination by fibroblasts. It has been demonstrated that detecting KRAS mutations, the most common and important mutations for the development of PDAC, by a qPCR-based method is accurate and highly sensitive (26). However, mutational analysis of other PDAC driver genes including TP53 , is relatively difficult.…”

Fully automated PCR detection of KRAS mutations on pancreatic endoscopic ultrasound fine-needle aspirates

“…Even if molecular biology cannot replace cytology, the presence of a KRAS mutation in an inconclusive EUS-FNA specimen taken from a solid lesion suggests malignancy, reducing the false-negative (FN) rate by 55.6%, according to a recent meta-analysis;8 conversely, the presence of wild-type KRAS may be evocative of benignity 8–11. However, the presence of KRAS mutations is not entirely specific, occurring in a minority of patients with CP11 and in preinvasive dysplastic lesions 12…”

Endoscopic Ultrasound in Pancreatic Cancer: The New Perspective

“…Another large study (n = 394 EUS-FNA samples) found 87% Kras mutations in pancreatic adenocarcinoma and only 3% in inflammatory masses and improved the accuracy of cancer diagnosis by 6% [112]. A recent meta-analysis showed that Kras detection in inconclusive EUS-FNA cases reduces the false-negative rate by 55.6%, with a false-positive rate of 10.7%, and the combined modality increases diagnostic accuracy from 80% to 88% [113].…”