Pancreatic ductal adenocarcinoma (PDAC) is supposed to become the second leading cancer-associated death by the next years. 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 the others: KRAS, TP53, CDKN2A/p16, and SMAD4. Sequencing, for example, is the preferable technique available for detecting KRAS mutations, while in situ immunochemistry is the main approach for detecting p53 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 this 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 a strict teamwork collaboration in order to improve the correct use of diagnostic sources. This article is protected by copyright. All rights reserved.

Team work and cytopathology molecular diagnosis of solid pancreatic lesions: A review

FASSAN, MATTEO;
2017

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is supposed to become the second leading cancer-associated death by the next years. 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 the others: KRAS, TP53, CDKN2A/p16, and SMAD4. Sequencing, for example, is the preferable technique available for detecting KRAS mutations, while in situ immunochemistry is the main approach for detecting p53 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 this 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 a strict teamwork collaboration in order to improve the correct use of diagnostic sources. This article is protected by copyright. All rights reserved.
2017
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/3221370
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