Pancreatic Cancer Diagnosis: Four Novel Histo-pathologies Screening Characteristics offers more Reliable Identification of Cellular Features associated with Cancer
News from University of Missouri, School of Medicine
Reporter: Aviva Lev-Ari, PhD, RN
“Through our analysis, we developed a group of four characteristics that allow a pathologist to diagnose pancreatic cancer with 93 percent accuracy — a substantial improvement over the traditional method,” Layfield said. “I believe this new technique can help pathologists improve the diagnosis of pancreatic cancer, ultimately improving care for patients by providing an evidence-based approach to diagnosing the disease and determining the best treatment.”
The four features of pancreatic cancer the researchers identified are:
- a wide variation in the size of pancreatic cells’ nuclei, called anisonucleosis
- oversized nucleoli, called macronucleoli
- single atypical epithelia cells, a type of cell found in the pancreas
- mucinous metaplasia, which is the production of mucin in cells that normally don’t produce the substance
The study, “Risk Stratification Using Morphological Features in Endoscopic-ultrasonography Guided Fine Needle Aspirations of Pancreatic Ductal Adenocarcinoma,” was presented at the American Society for Clinical Pathology‘s 2013 annual meeting.
MU Study Finds More Accurate Method to Diagnose Pancreatic Cancer
Group of four screening characteristics offers more reliable identification
Researchers from the University of Missouri have found a more accurate laboratory method for diagnosing pancreatic cancer, the fourth leading cause of cancer death in the United States. The disease causes more than 38,000 deaths each year in the United States, and kills 94 percent of people with the illness within five years, according to the National Cancer Institute.
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| Layfield |
“Pancreatic cancer can be difficult to diagnose because of subtle differences that distinguish between healthy tissue, cancerous tissue and tissue that is atypical, or suspicious,” said Lester Layfield, MD, professor and chair of the MU School of Medicine’s Department of Pathology and Anatomical Sciences. “Our goal was to find a way to make a more accurate and reproducible diagnosis.”
Because of the pancreas’ location within the body, no routine screening methods, such as mammography for breast cancer, exist for detecting pancreatic cancer.
If a physician suspects a patient may have pancreatic cancer, a biopsy of the pancreatic tissue is taken through a minimally invasive technique called endoscopic ultrasound-guided fine-needle aspiration.
“Traditionally, pathologists have examined a tissue sample through a microscope and made a diagnosis based on the overall features of all the cells in the tissue sample,” Layfield said. “Previous research has shown an experienced pathologist can diagnose pancreatic cancer with accuracy in the mid-to-upper 80 percent range using current techniques. However, we wanted to develop a more accurate method by determining which cellular features are most closely associated with cancer.”
To develop the new diagnostic method, MU researchers performed a retrospective study of the records from 57 patients at University of Missouri Health Care who were tested for pancreatic cancer. They evaluated 16 features of pancreatic biopsies that could be evaluated under a microscope and performed a statistical analysis to determine which could be most reliably identified by multiple pathologists and which were most likely to be associated with pancreatic cancer.
SOURCE
http://medicine.missouri.edu/news/0208.php?elq=0fef1d5f8bdf48c59a79cd939bd95e46&elqCampaignId=9
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This is very insightful. There is no doubt that there is the bias you refer to. 42 years ago, when I was postdocing in biochemistry/enzymology before completing my residency in pathology, I knew that there were very influential mambers of the faculty, who also had large programs, and attracted exceptional students. My mentor, it was said (although he was a great writer), could draft a project on toilet paper and call the NIH. It can’t be true, but it was a time in our history preceding a great explosion. It is bizarre for me to read now about eNOS and iNOS, and about CaMKII-á, â, ã, ä – isoenzymes. They were overlooked during the search for the genome, so intermediary metabolism took a back seat. But the work on protein conformation, and on the mechanism of action of enzymes and ligand and coenzyme was just out there, and became more important with the research on signaling pathways. The work on the mechanism of pyridine nucleotide isoenzymes preceded the work by Burton Sobel on the MB isoenzyme in heart. The Vietnam War cut into the funding, and it has actually declined linearly since.
A few years later, I was an Associate Professor at a new Medical School and I submitted a proposal that was reviewed by the Chairman of Pharmacology, who was a former Director of NSF. He thought it was good enough. I was a pathologist and it went to a Biochemistry Review Committee. It was approved, but not funded. The verdict was that I would not be able to carry out the studies needed, and they would have approached it differently. A thousand young investigators are out there now with similar letters. I was told that the Department Chairmen have to build up their faculty. It’s harder now than then. So I filed for and received 3 patents based on my work at the suggestion of my brother-in-law. When I took it to Boehringer-Mannheim, they were actually clueless.