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Review
. 2023 Mar 28;13(7):1275.
doi: 10.3390/diagnostics13071275.

Endoscopic Ultrasound-Guided Tissue Acquisition of Pancreaticobiliary Cancer Aiming for a Comprehensive Genome Profile

Susumu Hijioka  1 , Yoshikuni Nagashio  1 , Yuta Maruki  1 , Yuki Kawasaki  1 , Kotaro Takeshita  1 , Chigusa Morizane  1 , Takuji Okusaka  1
Affiliations
Review

Endoscopic Ultrasound-Guided Tissue Acquisition of Pancreaticobiliary Cancer Aiming for a Comprehensive Genome Profile

Susumu Hijioka et al. Diagnostics (Basel). .

Abstract

In recent years, cancer genomic medicine centered on comprehensive genome profile (CGP) analysis has become widely used in the field of pancreatic cancer. Endoscopic ultrasound-guided tissue acquisition (EUS-TA) has played an important role in pancreatic cancer, and recently, more EUS-TA tissue samples are considered for CGP analysis. Differences exist between the Oncoguide NCC Oncopanel System and Foundation One CDx Cancer Genome Profile, which are CGP tests approved by insurance programs in Japan, including the analysis criteria, optimal needle selection for meeting these criteria, and puncture target. It is important to understand not only the specimen collection factors, but also the specimen processing factors that can increase the success rate of CGP testing. Furthermore, cancer genome medicine is expected to enter an era of increasing turbulence in the future, and endoscopists need to respond flexibly to these changes. Herein, we review the current status of cancer genome medicine in pancreatic and biliary tract cancers and cancer gene panel testing using EUS-TA.

Keywords: Foundation One CDx cancer genome profile; Oncoguide NCC Oncopanel System; comprehensive genome profile; endoscopic ultrasound-guided tissue acquisition; pancreatic cancer; precision medicine.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Process from EUS-TA to CGP analysis and discussion points. CGP: comprehensive genome profile; EUS-TA: endoscopic ultrasound-guided tissue acquisition.
Figure 2
Figure 2
EUS-TA recommendations. For resectable/borderline resectable (BR) pancreatic cancer, 22-G FNB is the first choice because the main focus is on a benign/malignant diagnosis; however, 22-G FNA is selected in cases of difficult puncture. For unresectable pancreatic cancer and when CGP analysis is considered, 19-G FNB is the first choice; if CGP analysis is not planned, 22-G FNB is selected based on puncture performance and safety. CGP: comprehensive genome profile.
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