【佳学基因检测】与细胞学相比，EUS-FNA 分子分析在诊断胰腺囊性肿瘤方面是否具有附加价值？系统评价

靶向基因检测2万多重要性

挖掘肿瘤治疗的前沿研究在《肿瘤致病基因检测与转移潜能分析》收录《HPB (Oxford)》在. 2015 May;17(5):377-86.发表了一篇题目为《与细胞学相比，EUS-FNA 分子分析在诊断胰腺囊性肿瘤方面是否具有附加价值？系统评价》肿瘤靶向药物治疗基因检测临床研究文章。该研究由Amy Gillis, Ilaria Cipollone, Grainne Cousins, Kevin Conlon等完成。促进了肿瘤的精准治疗与个性化用药的发展，进一步强调了基因信息检测与分析的重要性。

肿瘤靶向药物及精准治疗临床研究内容关键词：

肿瘤靶向治疗基因检测临床应用结果

基因解码基因检测的研究介绍：细针穿刺超声内镜 (EUS-FNA) 已成为胰腺囊性病变 (PCL) 诊断中不可或缺的工具，对分子/DNA 异常的分析可能会提高术前诊断的准确性。对使用 PCL 的 EUS-FNA 抽吸物的所有研究进行了审查，以评估分子分析为细胞学分析提供的准确性和附加益处。基因解码基因检测的研究方法：使用 PRISMA 指南和电子数据库对文献进行系统审查：PubMed/SCOPUS/ EMBASE/Cochrane/CINAHL。手术病理学被用作最终的参考标准。 QUADAS-2 工具用于质量评估。基因解码基因检测的研究结果：共鉴定出 162 篇文章； 12 篇文章符合纳入/排除标准。 10 项研究报告了细胞学，8 项研究报告了 k-ras 突变分析。 362 名患者（共 1115 名）有手术病理可用。细胞学的敏感性和特异性分别为0.42和0.99； k-ras的敏感性和特异性分别为0.39和0.95；细胞学和k-ras联合检测的敏感性和特异性分别为0.71和0.88。基因解码基因检测的研究结论：k-ras突变分析作为个体筛查试验的诊断准确性较差，细胞学单独使用时同样如此。好处是结合使用。需要更多的研究来评估这些测试对囊肿分化的正确顺序和效用。

肿瘤发生与复发转移国际数据库描述：

Background: Endoscopic ultrasonography with fine needle aspiration (EUS-FNA) has become an integral tool in the diagnosis of pancreatic cystic lesions (PCLs) and the analysis of molecular/DNA abnormalities might improve the accuracy of pre-operative diagnosis. A review was conducted of all studies using EUS-FNA aspirates of PCLs to assess the accuracy and added benefit that molecular analysis provides to cytological analysis.Methods: A systematic review of the literature was conducted using PRISMA guidelines and electronic databases: PubMed/SCOPUS/EMBASE/Cochrane/CINAHL. Surgical pathology was used as the definitive reference standard. The QUADAS-2 tool was used for quality assessment.Results: In total, 162 articles were identified; 12 articles met inclusion/exclusion criteria. Ten studies reported on cytology and 8 studies reported k-ras mutational analysis. 362 patients (of 1115 total) had surgical pathology available. The sensitivity and specificity of cytology was 0.42 and 0.99; the sensitivity and specificity of k-ras was 0.39 and 0.95; and the sensitivity and specificity of the combined test of cytology and k-ras was 0.71 and 0.88, respectively.Conclusions: k-ras mutational analysis used as an individual screening test has a poor diagnostic accuracy, as does cytology when used alone. The benefit comes with utilization in a combined fashion. More studies are needed to evaluate the correct sequence and utility of these tests for cyst differentiation.