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Team work and cytopathology molecular diagnosis of solid pancreatic lesions
Author(s) -
Fabbri Carlo,
Gibiino Giulia,
Fornelli Adele,
Cennamo Vincenzo,
Grifoni Daniela,
Visani Michela,
Acquaviva Giorgia,
Fassan Matteo,
Fiorino Sirio,
Giovanelli Silvia,
Bassi Marco,
Ghersi Stefania,
Tallini Giovanni,
Jovine Elio,
Gasbarrini Antonio,
Biase Dario
Publication year - 2017
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12845
Subject(s) - kras , medicine , pancreatic cancer , fine needle aspiration , hematopathology , cytopathology , exome sequencing , molecular pathology , palb2 , endoscopic ultrasound , cancer , pathology , bioinformatics , computational biology , gene , mutation , colorectal cancer , biology , genetics , radiology , biopsy , germline mutation , cytology , cytogenetics , chromosome
Pancreatic ductal adenocarcinoma ( PDAC ) is expected to become the second leading cause of cancer‐associated death in the next decade or so. It is widely accepted that tumorigenesis is linked to specific alterations in key genes and pancreatic neoplasms are some of the best characterized at the genomic level. Recent whole‐exome and whole‐genome sequencing analyses confirmed that PDAC is frequently characterized by mutations in a set of four genes among others: KRAS , TP 53 , CDKN 2A / p16 , and SMAD 4 . Sequencing, for example, is the preferable technique available for detecting KRAS mutations, whereas in situ immunochemistry is the main approach for detecting TP53 gene alteration. Nevertheless, the diagnosis of PDAC is still a clinical challenge, involving adequate acquisition of endoscopic ultrasound ( EUS )‐guided fine‐needle aspiration ( FNA ) and specific pathological assessment from tissue architecture to specific biomolecular tests. The aim of the present review is to provide a complete overview of the current knowledge of the biology of pancreatic cancer as detected by the latest biomolecular techniques and, moreover, to propose a paradigm for strict teamwork collaboration in order to improve the correct use of diagnostic sources.