Citations 2
The Impact of Endoscopic Ultrasound and Multidisciplinary Team Evaluation on the Management of Pancreatic Cystic Lesions
Altayar, Osama , Hoegger, Mark J. , Chu, Linda, Zaheer, Atif , Zandieh, Ghazal , Kushnir, Vladimir , Lang, Gabriel , Goggins, Michael, Hawkins, William, Khan, Adeel , Burns, William, Lafaro, Kelly, Lim, Kian‐Huat, Pederson, Katrina, Das, Koushik K. , Altayar, Osama , Genere, Juan Reyes , Khan, Adeel , Das, Koushik , Dbouk, Mohamad H. , Genere, Juan Reyes , Rengarajan, Arvind , Mellnick, Vincent M. , Shetty, Anup S. , Goggins, Michael , Lafaro, Kelly J. , Lim, Kian-Huat , Afghani, Elham
United European Gastroenterology Journal | April 23, 2026 | Volume: 14 | Issue: 3 | Pages: No page available
ABSTRACT Background Retrospective evaluations of multidisciplinary team (MDT) review of pancreatic cystic lesions (PCL) demonstrate improved PCL management. Endoscopic ultrasound (EUS) evaluates PCL for worrisome features; however, its influence on MDT is unclear and may be attenuated by anchoring/confirmation bias. We aimed to evaluate the impact of EUS and the overall performance of MDT evaluation of PCL. Methods Four mock MDT sessions at two institutions were presented imaging from 40 consecutive PCL cases (20 “high‐risk” with advanced neoplasia, 20 “low‐risk” with pathologic low‐grade dysplasia or ≥ 3 years of non‐progression on surveillance), with and without upfront EUS/FNA (cytology, CEA, Amylase), in a randomized, crossover design. Group 1 adjudicated without EUS, Group 2 adjudicated with EUS, and Group 3 adjudicated with EUS after initially adjudicating without it. Results The cohort included branch‐duct ( n = 20), mixed type ( n = 6), and main duct ( n = 4) IPMN, MCN ( n = 5), and non‐mucinous PCL ( n = 5). Group 2 (EUS) correctly identified mucinous PCL with 97% sensitivity and 70% specificity, significantly higher than Group 1 (No EUS) (Sensitivity 91%, Specificity 20%; p = 0.04). Group 3 (Unblinded to EUS) performed significantly worse in mucinous PCL identification compared with Group 2, indicating cognitive bias (Sensitivity 97%, Specificity 10% ( p = 0.0003)). Group 2 correctly identified high‐risk PCL that required surgical intervention with 85% sensitivity and 85% specificity, significantly higher than Group 1 (Sensitivity 60%, Specificity 75%; p = 0.0016) and Group 3 (Sensitivity 73%, Specificity 80%, p = 0.0485). Conclusion While susceptible to cognitive bias, EUS significantly improves MDT assessment of PCL. MDT establishes a high bar for iterative additions of biomarkers to PCL analysis.
Novel Genetic Risk Loci for Pancreatic Ductal Adenocarcinoma Identified in a Genome-wide Study of African Ancestry Individuals
Ni, Zhanmo , Zhong, Jun , McKean, David, Antwi, Samuel O. , Bracci, Paige M., Du, Mengmeng, Gallinger, Steven, Genkinger, Jeanine, Haiman, Christopher A, Hassan, Manal, Huff, Chad , Kooperberg, Charles, Kastrinos, Fay , LeMarchand, Loic, Lee, WP, Oberg, Ann L. , Park, Margaret A. , Permuth, Jennifer B., Risch, Harvey A., Scheet, Paul , Schwartz, Ann, Shu, Xie, Wolpin, Brian M. , Albanes, Demetrius, Andreotti, Gabriella , Beane-Freeman, Laura, Berndt, Sonja I, Brennan, Paul, Buring, Julie E, Cabrera, Natalia, Campa, Daniele, Chanock, Stephen J, Chung, Charles C., Eliassen, A Heather, Gaziano, J. Michael, Giles, G G, Giovannucci, Edward L, Goggins, Michael, Goodman, Phyllis J. , Hicks, Belynda, Hutchinson, Amy , Jones , Katzke, Verena, Kogevinas, Manolis, Kurtz, Robert C. , Laheru, Daniel, Lee, I, Milne, Roger, Mucci, Lorelei, Patel, Alpa V, Peruchet, Laia, Peters, Ulrike, Porta, Miquel, Rabe, Kari G. , Real, Francisco X, Ricceri, Fulvio, Rothman, Nathaniel, Sesso, Howard D. , Setiawan, Veronica W, Debra, Silverman, Southey, M C, Stampfer, M I, Um, Caroline, Visvanathan, Kala, Wentzensen, Nicolas, Willett, Walter C, Kraft, Peter, Visvanathan, Kala , Zhong, Jun , Zheng, Wei , Canzian, Federico , Malats, Nuria , Duggal, Priya , Klein, Alison P , Chaffee, Kari G. , Antwi, Samuel O , Visvanathan, Kala , Vergara, Candelaria , McKean, David , Connelly, Katelyn E. , Arslan, Alan A. , Bracci, Paige M. , Du, Mengmeng, Genkinger, Jeanine M. , Haiman, Christopher A. , Hung, Rayjean J. , Kooperberg, Charles , Lynch, Shannon M. , Moore, Steven C. , Permuth, Jennifer B. , Risch, Harvey A., Schwartz, Ann, Stolzenberg‐Solomon, Rachael Z. , Zheng, Wei , Albanes, Demetrius , Bamlet, William R. , Berndt, Sonja I. , Brennan, Paul, Buring, Julie E. , Cabrera-Castro, Natalia , Canzian, Federico , Chanock, Stephen Jacob , Chen, Yu , Gaziano, J. Michael , Giovannucci, Edward L. , Goggins, Michael , Hicks, Belynda , Katzke, Verena , Kogevinas, Manolis , Laheru, Daniel A. , Malats, Núria , Milne, Roger, Mucci, Lorelei A. , Neale, Rachel Ε. , Orlow, Irene , Peruchet‐Noray, Laia , Peters, Ulrike , Real, Francisco X. , Ricceri, Fulvio , Rothman, Nathaniel , Setiawan, Veronica Wendy , Silverman, Debra T. , Southey, Melissa C , Stampfer, Meir J. , Tobias, Geoffrey S. , Um, Caroline Y. , Wactawski‐Wende, Jean , Wentzensen, Nicolas , Yu, Kai , Duggal, Priya , Ámundadóttir, Laufey T. , Klein, Alison P.
No container title available | April 23, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Pancreatic cancer disproportionately affects Black individuals in the United States, but they have limited representation in genetic studies of pancreatic ductal adenocarcinoma (PDAC). To address this gap, we performed admixture mapping and genome-wide association analysis (GWAS) in genetically inferred African ancestry individuals (1,030 cases and 889 controls). Admixture mapping identified three regions with a significantly higher proportion of African ancestry in cases compared to controls (5q33.3, 10p1, 22q12.3). GWAS identified a genome-wide significant association at 5p15.33 ( CLPTM1L , rs383009:T>C, T Allele Frequency=0.51, OR:1.45, P value=1.24×10 -8 ), a locus previously associated with PDAC. Known loci at 5p15.33, 7q32.3, 8q24.21 and 7q25.1 also replicated (P value <0.01). Multi-ancestral fine-mapping identified two potential causal SNPs (rs3830069 and rs2735940) at 5p15.33. Collectively these findings identified novel PDAC risk loci and expanded our understanding of this deadly cancer in underrepresented populations, emphasizing the multifactorial nature of PDAC risk including inherited genetic and non-genetic factors. Statement of Significance To understand how genetic variation contributes to PDAC risk in Black people in North American, we studied individuals of genetically-inferred African ancestry. We identified novel risk loci and differences in the contribution of known loci. This demonstrates that ancestry-informed genetic analyses improve our understanding of PDAC risk and enhances discovery.