Unknown

Dataset Information

0

Novel Methylated DNA Markers Discriminate Advanced Neoplasia in Pancreatic Cysts: Marker Discovery, Tissue Validation, and Cyst Fluid Testing.


ABSTRACT: OBJECTIVES:Pancreatic cystic lesions (PCLs) may be precancerous. Those likely to harbor high-grade dysplasia (HGD) or pancreatic cancer (PC) are targets for surgical resection. Current algorithms to predict advanced neoplasia (HGD/PC) in PCLs lack diagnostic accuracy. In pancreatic tissue and cyst fluid (CF) from PCLs, we sought to identify and validate novel methylated DNA markers (MDMs) that discriminate HGD/PC from low-grade dysplasia (LGD) or no dysplasia (ND). METHODS:From an unbiased whole-methylome discovery approach using predefined selection criteria followed by multistep validation on case (HGD or PC) and control (ND or LGD) tissues, we identified discriminant MDMs. Top candidate MDMs were then assayed by quantitative methylation-specific polymerase chain reaction on archival CF from surgically resected PCLs. RESULTS:Of 25 discriminant MDMs identified in tissue, 13 were selected for validation in 134 CF samples (21 cases [8 HGD, 13 PC], 113 controls [45 ND, 68 LGD]). A tree-based algorithm using 2 CF-MDMs (TBX15, BMP3) achieved sensitivity and specificity above 90%. Discrimination was significantly better by this CF-MDM panel than by mutant KRAS or carcinoembryonic antigen, with areas under the receiver operating characteristic curve of 0.93 (95% confidence interval: 0.86-0.99), 0.71 (0.57-0.85), and 0.72 (0.60-0.84), respectively. Cutoffs for the MDM panel applied to an independent CF validation set (31 cases, 56 controls) yielded similarly high discrimination, areas under the receiver operating characteristic curve = 0.86 (95% confidence interval: 0.77-0.94, P = 0.2). DISCUSSION:Novel MDMs discovered and validated in tissue accurately identify PCLs harboring HGD/PC. A panel of 2 MDMs assayed in CF yielded results with potential to enhance current risk prediction algorithms. Prospective studies are indicated to optimize and further evaluate CF-MDMs for clinical use.

SUBMITTER: Majumder S 

PROVIDER: S-EPMC7294458 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

altmetric image

Publications

Novel Methylated DNA Markers Discriminate Advanced Neoplasia in Pancreatic Cysts: Marker Discovery, Tissue Validation, and Cyst Fluid Testing.

Majumder Shounak S   Taylor William R WR   Yab Tracy C TC   Berger Calise K CK   Dukek Brian A BA   Cao Xiaoming X   Foote Patrick H PH   Wu Chung Wah CW   Mahoney Douglas W DW   Aslanian Harry R HR   Fernández-Del Castillo Carlos C   Doyle Leona A LA   Farrell James J JJ   Fisher William E WE   Lee Linda S LS   Lee Yvonne N YN   Park Walter W   Rodrigues Clifton C   Gould Rothberg Bonnie Elyssa BE   Salem Ronald R RR   Simeone Diane M DM   Urs Sumithra S   Van Buren George G   Smyrk Thomas C TC   Allawi Hatim T HT   Lidgard Graham P GP   Raimondo Massimo M   Chari Suresh T ST   Kendrick Michael L ML   Kisiel John B JB   Topazian Mark D MD   Ahlquist David A DA  

The American journal of gastroenterology 20190901 9


<h4>Objectives</h4>Pancreatic cystic lesions (PCLs) may be precancerous. Those likely to harbor high-grade dysplasia (HGD) or pancreatic cancer (PC) are targets for surgical resection. Current algorithms to predict advanced neoplasia (HGD/PC) in PCLs lack diagnostic accuracy. In pancreatic tissue and cyst fluid (CF) from PCLs, we sought to identify and validate novel methylated DNA markers (MDMs) that discriminate HGD/PC from low-grade dysplasia (LGD) or no dysplasia (ND).<h4>Methods</h4>From an  ...[more]

Similar Datasets

| S-EPMC7923255 | biostudies-literature
| S-EPMC8479274 | biostudies-literature
| S-EPMC3547600 | biostudies-literature
| S-EPMC9638530 | biostudies-literature
| S-EPMC6239895 | biostudies-literature
| S-EPMC11307501 | biostudies-literature
| S-EPMC5023405 | biostudies-literature
| S-EPMC4373821 | biostudies-literature
| S-EPMC5511555 | biostudies-literature
| S-EPMC3641952 | biostudies-literature