Targeted next-generation sequencing of FNA-derived DNA in pancreatic cancer

J Clin Pathol. 2017 Feb;70(2):174-178. doi: 10.1136/jclinpath-2016-203928. Epub 2016 Sep 26.

Abstract

To improve the diagnostic value of fine-needle aspiration (FNA)-derived material, we perform targeted next-generation sequencing (NGS) in patients with a suspect lesion of the pancreas. The NGS analysis can lead to a change in the treatment plan or supports inconclusive or uncertain cytology results. We describe the advantages of NGS using one particular patient with a recurrent pancreatic lesion 7 years after resection of a pancreatic ductal adenocarcinoma (PDAC). Our NGS analysis revealed the presence of a presumed second primary cancer in the pancreatic remnant, which led to a change in treatment: resection with curative intend instead of palliation. Additionally, NGS identified an unexpected germline CDKN2A 19-base pair deletion, which predisposed the patient to developing PDAC. Preoperative NGS analysis of FNA-derived DNA can help identify patients at risk for developing PDAC and define future therapeutic options.

Keywords: CANCER; DIAGNOSTICS; DNA; MOLECULAR PATHOLOGY; PANCREAS.

MeSH terms

  • Biopsy, Fine-Needle
  • Carcinoma, Pancreatic Ductal / metabolism
  • Carcinoma, Pancreatic Ductal / pathology*
  • Carcinoma, Pancreatic Ductal / surgery
  • DNA
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / metabolism
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery
  • Sequence Analysis, DNA
  • Treatment Outcome

Substances

  • DNA