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Detection of microsatellite alteration in serum DNA as a tool for differentiation between benign and malignant diseases of the pancreas
Robin Wachowiak1, Jussuf T. Kaifi1, Bjoern C. Link1, Dean Bogoevski1, Guellue Cataldegirmen1, Uta Reichelt2, Lars Wolfram1, Jakob R. Izbicki1, Emre F. Yekebas1; 1General, Visceral and Thoracic Surgery, University Clinic Hamburg-Eppendorf, Hamburg, Germany; 2Institute of Pathology, University Clinic Hamburg-Eppendorf, Hamburg, Germany

Background: The diagnosis of pancreatic masses to distinguish pancreatic carcinoma from chronic pancreatitis may be difficult. In patients with pancreatic masses of dubious dignity, the detection of tumor specific DNA alterations like "Loss of heterozygosity" could be a helpful tool in an easily accessible anatomical compartment. Methods: DNA was analysed from serum and peripheral blood from 24 patients with ductal adenocarcinoma of the pancreas, 12 patients with chronic pancreatitis and 12 healthy individuals. In total, 12 microsatellite markers were investigated. Results: Twenty-two (92%) of 24 carcinoma patients had one or more alterations in the serum DNA. In contrast, only four (33%) of 12 patients with chronic pancreatitis had one LOH in the serum. In the serum DNA of the 12 healthy individuals, no LOH was detected. Specificity of the 12 markers examined ranged from 50 % to 100%, whereas sensitivity was 3% to 78%. LOH was identified most frequently with a sensitivity of 56% and a specificity of 91% at the microsatellite marker region D17S787 localized on chromosome 17. Conclusion: In comparison to patients with chronic pancreatitis, a high incidence of LOH appeared in the serum DNA of pancreatic carcinoma patients. Microsatellite detection in easily accessible serum of pancreatic carcinoma patients could be an important tool for early and differential diagnosis of unclear pancreatic masses.

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