ArticleJournal of gastroenterology2026
Diagnostic performance of droplet digital PCR for KRAS mutation analysis in pancreatic cancer cytology specimens.
Article in Journal of gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe identification of KRAS mutations is increasingly crucial for managing pancreatic cancer, especially with the development of novel KRAS inhibitors. However, obtaining sufficient tissue for genomic profiling is often challenging. This study evaluated the clinical utility of droplet digital PCR (ddPCR) for rapid KRAS mutation analysis using residual cytology wash fluid from EUS-FNA.
methodsWe analyzed 38 patients with pancreatic cancer. KRAS mutations were measured in tumor tissue and cytology specimens using ddPCR (threshold 0.1%) and compared with next-generation sequencing (NGS) of tissue specimens (threshold 1.0%). Additionally, the concordance of ddPCR results between tissue and cytology specimens was also evaluated.
resultsThe analysis completion rate for ddPCR was 100%. For the overall identification of KRAS mutations (presence or absence), perfect agreement (100%, 38/38 cases) was observed between tissue NGS and cytology ddPCR, and between tissue ddPCR and cytology ddPCR. The concordance for the variant with the highest allele frequency (VAF) in the comparison between tissue NGS and cytology ddPCR was 92% (35/38 cases), reaching 100% in cases with a tissue VAF > 5%. Similarly, in the cross-specimen comparison between tissue and cytology using ddPCR, the concordance for the highest VAF variant was 92% (35/38 cases), with 100% (32/32 cases) agreement for specimens with a VAF > 5%. These results demonstrate high consistency across both platforms and specimen types.
conclusionsddPCR analysis of cytology specimens is a highly viable option for KRAS mutation assessment. Its high sensitivity enables molecular profiling using residual diagnostic materials, facilitating rapid clinical decision-making without requiring additional tissue collection in pancreatic cancer management.
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