The impact of targeted next-generation DNA sequencing on the diagnostic accuracy of endoscopic ultrasound-guided tissue sampling of focal pancreatic lesions

IF 3.9 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology Pub Date : 2026-06-01 Epub Date: 2026-04-04 DOI:10.1016/j.pan.2026.04.003

Suzane Ribeiro , Emine Gökce , Siebe Loontiens , Luis Abreu de Carvalho , Clarisse Lecluyse , Niki Rashidian , Filip Gryspeerdt , Frederik Berrevoet , Anne Hoorens , Joni Van der Meulen , Pieter Hindryckx , Karen Geboes

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引用次数: 0

Abstract

Background

Accurate diagnosis of pancreatic lesions remains challenging. This study evaluated the diagnostic value of targeted DNA-based next-generation sequencing (NGS) of tissue obtained by endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) and its contribution to pancreaticobiliary multidisciplinary tumor board (MDTB) discussions.

Methods

A retrospective analysis was conducted using a prospectively maintained database at Ghent University Hospital (March 2021–September 2024). Only patients undergoing targeted DNA NGS on EUS-FNA/FNB samples were included and reviewed during MDTB meetings. Diagnostic performance and influence on management were compared with final diagnoses established by clinical follow-up and/or surgical pathology.

Results

The final cohort comprised 120 focal pancreatic lesions. Ninety-one percent of solid masses (50/55) were malignancies. Cytopathology alone identified pancreatic cancer (PC) or high-grade dysplasia (HGD) in 27 cases (sensitivity 54%), whereas NGS alone identified 42 (sensitivity 84%). Combined cytopathology and NGS detected 45/50 malignancies (90%). Only two samples were non-diagnostic, yielding an overall diagnostic success of 96% (53/55).

NGS was technically successful in 33/65 (51%) cystic lesions. Surgery was undertaken in 20 patients, with HGD or carcinoma confirmed in 11 (55%). Molecular profiling combined with cytopathology guided surgical decision-making in 6/11 patients (54%) compared with 3/11 (27%) with cytopathology alone.

Conclusion

Targeted NGS improves diagnostic accuracy in solid pancreatic lesions and supports surgical decision-making for cystic lesions. Integration of molecular findings into MDTB discussions enhances precision and timeliness of pancreatic cancer treatment.

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靶向下一代DNA测序对内镜超声引导下局灶性胰腺病变组织采样诊断准确性的影响。

背景：胰腺病变的准确诊断仍然具有挑战性。本研究评估了内镜超声引导下细针穿刺/活检（EUS-FNA/FNB）获得的组织靶向dna新一代测序（NGS）的诊断价值及其对胰胆管多学科肿瘤委员会（MDTB）讨论的贡献。方法：使用根特大学医院前瞻性维护的数据库（2021年3月- 2024年9月）进行回顾性分析。只有对EUS-FNA/FNB样本进行靶向DNA NGS的患者被纳入MDTB会议并进行审查。通过临床随访和/或手术病理确定最终诊断，比较诊断表现和对治疗的影响。结果：最终队列包括120个局灶性胰腺病变。91%的实性肿块（50/55）为恶性肿瘤。细胞病理学单独发现胰腺癌（PC）或高级别不典型增生（HGD） 27例（敏感性54%），而NGS单独发现42例（敏感性84%）。结合细胞病理学和NGS检测到45/50例恶性肿瘤（90%）。只有两个样本是非诊断性的，总体诊断成功率为96%（53/55）。NGS在技术上成功治疗了33/65（51%）囊性病变。20例患者接受手术，其中11例（55%）确诊为HGD或癌。分子图谱联合细胞病理学指导手术决策的患者为6/11(54%)，而单独细胞病理学指导手术决策的患者为3/11（27%）。结论：靶向NGS可提高胰腺实性病变的诊断准确性，为囊性病变的手术决策提供支持。将分子发现整合到MDTB讨论中可以提高胰腺癌治疗的准确性和及时性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pancreatology 医学-胃肠肝病学

CiteScore

7.20

自引率

5.60%

发文量

194

审稿时长

44 days

期刊介绍： Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.