Endoscopic ultrasound-guided tissue acquisition and gene panel testing for pancreatic cancer

Abstract

In the era of genomic medicine, there is a growing need to obtain tissue samples suitable for tumor genotyping. Recent studies have focused on the development of optimal devices and techniques in endoscopic ultrasound-guided tissue acquisition (EUS-TA) for pancreatic cancer. In addition to sufficient tissue acquisition, it is also necessary to optimize preanalytical steps (e.g. sample processing, formalin fixation, and specimen preparation for analysis) to improve the success rate of gene panel testing. Close cooperation with pathologists and technicians is essential for successful analysis. However, in some cases, it is still challenging to obtain sufficient tissue samples. In such cases, we should consider other methods of genomic testing such as plasma cell-free DNA genotyping, microsatellite instability testing, and germline BRCA1/2 testing depending on the patient's condition. In this review, we discuss the role of EUS-TA in the clinical practice of gene panel testing for pancreatic cancer.