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首页> 外文期刊>Endoscopy International Open >Genetic analysis of postoperative recurrence of pancreatic cancer potentially owing to needle tract seeding during EUS-FNB
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Genetic analysis of postoperative recurrence of pancreatic cancer potentially owing to needle tract seeding during EUS-FNB

机译：EUS-FNB术后针道播种的胰腺癌术后复发的遗传分析

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Background and study aims?Needle tract seeding during endoscopic ultrasound fine-needle biopsy (EUS-FNB) remains a concern. We investigated whether such seeding occurred in a patient with pancreatic ductal adenocarcinoma (PDA). Patient and methods?Surgically resected and EUS-FNB-derived specimens were genotyped to determine if a gastric wall tumor that emerged 3 years after curative resection of an early-stage PDA was clonally related to the original tumor. Results?The gastric tumor histologically resembled the primary PDA; the lesions also shared KRAS, SMAD4, and RNF43 mutations. Genotyping of the preoperative EUS-FNB specimen, in which cancer was not detected, nevertheless revealed mutations that were identical to those in the resected primary and recurrent tumors. While the primary PDA had a low frequency of mutant SMAD4, such mutations were highly prevalent in both the EUS-FNB and recurrent tumor specimens. Conclusions?The genetic lineages of sampled tissues from our patient revealed that needle tract seeding may have incidentally occurred when a subset of neoplastic cells within a heterogeneous tumor (i.?e., an aggressive clone) was targeted during EUS-FNB.
机译：背景和研究旨在？内镜超声细针活检（EUS-FNB）期间的针道播种仍然是一个问题。我们调查了这种种子是否发生在患有胰腺导管腺癌（PDA）的患者中。患者和方法？手术切除和EUS-FNB衍生的标本进行基因分型，以确定早期PDA治疗后3年后出现的胃壁肿瘤是否与原始肿瘤克隆有关。结果？胃肿瘤组织学类似地称为初级PDA;病变也共享KRA，SMAD4和RNF43突变。术前EUS-FNB样本的基因分型，其中未检测到癌症，揭示了与切除的原发性和复发性肿瘤中的突变相同。虽然初级PDA具有低频率的突变体Smad4，但在EUS-FNB和复发性肿瘤标本中，这种突变高度普遍。结论？来自我们患者的采样组织的遗传谱系显示，当在EUS-FNB期间靶向肿瘤细胞的肿瘤细胞子集时，针道播种可能偶然发生。

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