Journal Article

Diagnostic value of CA19.9, circulating tumour DNA and circulating tumour cells in patients with solid pancreatic tumours

Iwanicki-Caron, Isabelle, Sarafan-Vasseur, Nasrin, Michel, Pierre, Schwarz, Lilian, Alhameedi, Raied, Tuech, Jean-Jacques, Jardin, Fabrice, Di Fiore, Frédéric, Blanchard, France, Dolfus, Claire, Clatot, Florian, Sabourin, Jean-Christophe, Antonietti, Michel, Paresy, Marianne, Toure, Emmanuel, Perdrix, Anne, Gangloff, Alice, Basile, Paul, Sefrioui, David, Beaussire, Ludivine, Lecleire, Stephane, Frébourg, Thierry

2017

Overview

Background: The direct comparison of CA19.9, circulating tumour cells (CTCs) and circulating tumour DNA (ctDNA) using endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has never been performed for the diagnosis of solid pancreatic tumours (SPTs). Methods: We included 68 patients with a SPT referred for EUS-FNA. CTCs were analysed using size-based platform and ctDNA using digital PCR. The sensitivity, specificity, negative and positive predictive values were evaluated for each marker and their combination. Results: SPTs corresponded to 58 malignant tumours (52 pancreatic adenocarcinoma (PA) and 6 others) and 10 benign lesions. The sensitivity and specificity for PA diagnosis were 73% and 88% for EUS-FNA, 67% and 80% for CTC, 65% and 75% for ctDNA and 79% and 93% for CA19.9, respectively. The positivity of at least 2 markers was associated with a sensitivity and specificity of 78% and 91%, respectively. CtDNA was the only marker associated with overall survival (median 5.2 months for ctDNA+ vs 11.0 months for ctDNA−, P =0.01). Conclusions: CA19.9 alone and in combination with ctDNA and/or CTC analysis may represent an efficient method for diagnosing PA in patients with SPTs. Further studies including a larger cohort of patients with both malignant and benign lesions will be necessary to confirm these promising results.

• Publisher: Nature Publishing Group UK,Nature Publishing Group,Cancer Research UK
• Subject: 631/67/1504/1713 / 631/67/68 / Adenocarcinoma / Adenocarcinoma - blood / Adenocarcinoma - diagnosis / Adenocarcinoma - genetics / Adenocarcinoma - pathology / Adolescent / Adult / Aged / Aged, 80 and over / Benign / Biomarkers, Tumor - blood / Biomedical and Life Sciences / Biomedicine / CA-19-9 Antigen - blood / Cancer / Cancer Research / DNA, Neoplasm - blood / Drug Resistance / Endoscopic Ultrasound-Guided Fine Needle Aspiration / Epidemiology / Female / Follow-Up Studies / Human health and pathology / Humans / Hépatology and Gastroenterology / Life Sciences / Male / Mammography / Medical diagnosis / Middle Aged / Molecular Diagnostics / Molecular Medicine / Neoplastic Cells, Circulating / Oncology / Pancreas / Pancreatic cancer / Pancreatic Neoplasms - blood / Pancreatic Neoplasms - diagnosis / Pancreatic Neoplasms - genetics / Pancreatic Neoplasms - pathology / Predictive Value of Tests / Proto-Oncogene Proteins p21(ras) - genetics / Survival Rate / Tumors / Ultrasound / Young Adult