Addressing the unmet clinical need for low-volume assays in early diagnosis of pancreatic cancer
The incidental detection of pancreatic cysts, an opportunity for the early detection of pancreatic cancer, is increasing, owing to an aging population and improvements in imaging technology. The classification of pancreatic cystic precursors currently relies on imaging and cyst fluid evaluations, in...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Gastroenterology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fgstr.2023.1258998/full |
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| author | Daniel A. Sheik Kaleb Byers Mini Thomas Ummadisetti Chinna Rajesh Kelli Ifuku Kimberly Kirkwood Mohammed Al-Haddad Charles S. Craik V. Jo Davisson V. Jo Davisson |
| author_facet | Daniel A. Sheik Kaleb Byers Mini Thomas Ummadisetti Chinna Rajesh Kelli Ifuku Kimberly Kirkwood Mohammed Al-Haddad Charles S. Craik V. Jo Davisson V. Jo Davisson |
| author_sort | Daniel A. Sheik |
| collection | DOAJ |
| description | The incidental detection of pancreatic cysts, an opportunity for the early detection of pancreatic cancer, is increasing, owing to an aging population and improvements in imaging technology. The classification of pancreatic cystic precursors currently relies on imaging and cyst fluid evaluations, including cytology and protein and genomic analyses. However, there are persistent limitations that obstruct the accuracy and quality of information for clinicians, including the limited volume of the complex, often acellular, and proteinaceous milieu that comprises pancreatic cyst fluid. The constraints of currently available clinical assays lead clinicians to the subjective and inconsistent application of diagnostic tools, which can contribute to unnecessary surgery and missed pancreatic cancers. Herein, we describe the pathway toward pancreatic cyst classification and diagnosis, the volume requirements for several clinically available diagnostic tools, and some analytical and diagnostic limitations for each assay. We then discuss current and future work on novel markers and methods, and how to expand the utility of clinical pancreatic cyst fluid samples. Results of ongoing studies applying SERS as a detection mode suggest that 50 µL of pancreatic cyst fluid is more than sufficient to accurately rule out non-mucinous pancreatic cysts with no malignant potential from further evaluation. This process is expected to leave sufficient fluid to analyze a follow-up, rule-in panel of markers currently in development that can stratify grades of dysplasia in mucinous pancreatic cysts and improve clinical decision-making. |
| first_indexed | 2024-03-11T23:35:29Z |
| format | Article |
| id | doaj.art-ed841835040243edba0ad6e8d70b037f |
| institution | Directory Open Access Journal |
| issn | 2813-1169 |
| language | English |
| last_indexed | 2024-03-11T23:35:29Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Gastroenterology |
| spelling | doaj.art-ed841835040243edba0ad6e8d70b037f2023-09-20T04:46:41ZengFrontiers Media S.A.Frontiers in Gastroenterology2813-11692023-09-01210.3389/fgstr.2023.12589981258998Addressing the unmet clinical need for low-volume assays in early diagnosis of pancreatic cancerDaniel A. Sheik0Kaleb Byers1Mini Thomas2Ummadisetti Chinna Rajesh3Kelli Ifuku4Kimberly Kirkwood5Mohammed Al-Haddad6Charles S. Craik7V. Jo Davisson8V. Jo Davisson9Research and Technology Department, Amplified Sciences, Inc, West Lafayette, IN, United StatesResearch and Technology Department, Amplified Sciences, Inc, West Lafayette, IN, United StatesResearch and Technology Department, Amplified Sciences, Inc, West Lafayette, IN, United StatesResearch and Technology Department, Amplified Sciences, Inc, West Lafayette, IN, United StatesDepartment of Surgery, University of California, San Francisco, CA, United StatesDepartment of Surgery, University of California, San Francisco, CA, United StatesDivision of Gastroenterology and Hepatology, Indiana University (IU) School of Medicine, Indianapolis, IN, United StatesDepartment of Pharmaceutical Chemistry, University of California, San Francisco, San Francisco, CA, United StatesResearch and Technology Department, Amplified Sciences, Inc, West Lafayette, IN, United StatesDepartment of Medicinal Chemistry and Molecular Pharmacology, Purdue University College of Pharmacy, West Lafayette, IN, United StatesThe incidental detection of pancreatic cysts, an opportunity for the early detection of pancreatic cancer, is increasing, owing to an aging population and improvements in imaging technology. The classification of pancreatic cystic precursors currently relies on imaging and cyst fluid evaluations, including cytology and protein and genomic analyses. However, there are persistent limitations that obstruct the accuracy and quality of information for clinicians, including the limited volume of the complex, often acellular, and proteinaceous milieu that comprises pancreatic cyst fluid. The constraints of currently available clinical assays lead clinicians to the subjective and inconsistent application of diagnostic tools, which can contribute to unnecessary surgery and missed pancreatic cancers. Herein, we describe the pathway toward pancreatic cyst classification and diagnosis, the volume requirements for several clinically available diagnostic tools, and some analytical and diagnostic limitations for each assay. We then discuss current and future work on novel markers and methods, and how to expand the utility of clinical pancreatic cyst fluid samples. Results of ongoing studies applying SERS as a detection mode suggest that 50 µL of pancreatic cyst fluid is more than sufficient to accurately rule out non-mucinous pancreatic cysts with no malignant potential from further evaluation. This process is expected to leave sufficient fluid to analyze a follow-up, rule-in panel of markers currently in development that can stratify grades of dysplasia in mucinous pancreatic cysts and improve clinical decision-making.https://www.frontiersin.org/articles/10.3389/fgstr.2023.1258998/fullrule-outrule-indysplasiaearly diagnosissurface-enhanced Raman spectroscopypancreatic cancer |
| spellingShingle | Daniel A. Sheik Kaleb Byers Mini Thomas Ummadisetti Chinna Rajesh Kelli Ifuku Kimberly Kirkwood Mohammed Al-Haddad Charles S. Craik V. Jo Davisson V. Jo Davisson Addressing the unmet clinical need for low-volume assays in early diagnosis of pancreatic cancer Frontiers in Gastroenterology rule-out rule-in dysplasia early diagnosis surface-enhanced Raman spectroscopy pancreatic cancer |
| title | Addressing the unmet clinical need for low-volume assays in early diagnosis of pancreatic cancer |
| title_full | Addressing the unmet clinical need for low-volume assays in early diagnosis of pancreatic cancer |
| title_fullStr | Addressing the unmet clinical need for low-volume assays in early diagnosis of pancreatic cancer |
| title_full_unstemmed | Addressing the unmet clinical need for low-volume assays in early diagnosis of pancreatic cancer |
| title_short | Addressing the unmet clinical need for low-volume assays in early diagnosis of pancreatic cancer |
| title_sort | addressing the unmet clinical need for low volume assays in early diagnosis of pancreatic cancer |
| topic | rule-out rule-in dysplasia early diagnosis surface-enhanced Raman spectroscopy pancreatic cancer |
| url | https://www.frontiersin.org/articles/10.3389/fgstr.2023.1258998/full |
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