K-ras, p53, and DPC4 (MAD4) alterations in fine-needle aspirates of the pancreas: A molecular panel correlates with and supplements cytologic diagnosis

Tjarda Van Heek, Anne E. Rader, G. Johan A. Offerhaus, Denis M. McCarthy, Michael Goggins, Ralph H. Hruban, Robb E. Wilentz

Research output: Contribution to journalArticle

Abstract

Between January 1997 and February 2000, 101 fine-needle pancreatic aspirates were obtained. After a cytologic diagnosis was made, possible molecular alterations were determined on the 94 aspirates with adequate tissue using a molecular panel (K-ras, p53, and DPC4 [MAD4] genes). The 94 aspirates were categorized as follows: diagnostic of adenocarcinoma, 48 (51%); atypical (suggestive of, but not diagnostic of, adenocarcinoma), 19 (20%); negative for adenocarcinoma, 25 (27%); diagnostic of a neoplasm other than adenocarcinoma, 2 (2%). Clinical follow-up revealed that 3 patients (12%) with negative cytologic diagnoses and 12 patients (63%) with atypical cytologic diagnoses had adenocarcinoma. Of 63 with a final diagnosis of adenocarcinoma, 42 (67%) had an alteration in at least 1 of the genes analyzed. In contrast, only 2 (6%) of 31 patients without adenocarcinoma had an alteration in 1 gene on the panel. Overall, the molecular analyses supported the diagnosis of adenocarcinoma in 6 (32%) of 19 aspirates originally diagnosed as atypical by cytology alone. A molecular panel that includes the K-ras, p53, and DPC4 (MAD4) genes correlates with and can supplement traditional cytologic diagnosis of pancreatic fine-needle aspirates.

Original languageEnglish (US)
Pages (from-to)755-765
Number of pages11
JournalAmerican journal of clinical pathology
Volume117
Issue number5
DOIs
StatePublished - May 11 2002

Keywords

  • Cytology
  • Cytopathology
  • Dpc4
  • Fine-needle aspiration
  • Genetics
  • K-ras
  • P53
  • Pancreas

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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