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Pancreatic Neoplasms: HELP
Articles by Abdurrahman Kadayifci
Based on 8 articles published since 2010
(Why 8 articles?)
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Between 2010 and 2020, Abdurrahman Kadayifci wrote the following 8 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Clinical Trial Imaging of pancreatic cystic lesions with confocal laser endomicroscopy: an ex vivo pilot study. 2017

Kadayifci, Abdurrahman / Atar, Mustafa / Yang, Michelle / Fernandez-Del Castillo, Carlos / Mino-Kenudson, Mari / Brugge, William R. ·Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. kadayifci@hotmail.com. · Division of Gastroenterology, University of Gaziantep, University street, 27060, Gaziantep, Turkey. kadayifci@hotmail.com. · Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. · Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, USA. · Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. ·Surg Endosc · Pubmed #28444494.

ABSTRACT: BACKGROUND: The differential diagnosis of pancreatic cystic lesions (PCLs) is an increasingly common clinical challenge. Confocal laser endomicroscopy (CLE) may differentiate PCLs by imaging of the cyst wall. However, clinical experience is still limited, and better image definition and characterization of the cyst wall in a spectrum of cysts are needed. This experimental study aimed to expose detailed imaging characteristics of PCLs by CLE. METHODS: Patients who underwent surgery of a PCL were enrolled. During surgery, intravenous fluorescein (2.5 ml of 10%) was injected just prior to the ligation of blood vessels supplying the pancreas. The freshly excised specimens were transected along the long axis to fully expose the luminal surface. A Gastroflex-UHD CLE probe (pCLE) was used manually to acquire images directly from the surface of cyst wall. The specimen subsequently underwent cross-sectional histology. All recorded data were analyzed by two investigators for predefined and original image findings of PCLs. RESULTS: Ten cases were recruited into the study. All patients underwent surgery because of a mucinous cyst with worrisome features or a symptomatic PCL. Imaging was successful in all patients and differently shaped papillary projections (PP) were visualized in eight patients. Pathological examination of those patients confirmed 6 cases with Intraductal Papillary Mucinous Neoplasm (IPMN) and 2 cases with Mucinous Cystic Neoplasm (MCN). In two patients with serous cystadenoma, typical vascular network was visualized in one patient, and microcystic structures in the other. Three of the IPMNs were malignant. The loss of papillary margin integrity and significant fragmentation together with irregularity was detected in malignant IPMNs by CLE. CONCLUSIONS: Pancreatic cyst epithelial wall can be visualized successfully by pCLE in ex vivo surgical specimens. Different papillary projections have been seen in all cases of IPMNs and MCNs. CLE has potential for identifying IPMN subtypes and for grading dysplasia.

2 Article Ex vivo human bile duct radiofrequency ablation with a bipolar catheter. 2018

Atar, Mustafa / Kadayifci, Abdurrahman / Daglilar, Ebubekir / Hagen, Catherine / Fernandez-Del Castillo, Carlos / Brugge, William R. ·Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, 3-H GI Associates, Zero Emerson Place, Blossom St., Boston, MA, 02114, USA. · Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, 3-H GI Associates, Zero Emerson Place, Blossom St., Boston, MA, 02114, USA. kadayifci@hotmail.com. · Unit of Gastroenterology, Reyap Istanbul Hospital, Istanbul, Turkey. kadayifci@hotmail.com. · Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. · Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA. · Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. ·Surg Endosc · Pubmed #29264758.

ABSTRACT: BACKGROUND: Management of the primary and secondary tumors of the bile ducts still remains as a major clinical challenge. Radiofrequency (RF) ablation (RFA) of these tumors is feasible but the effect of RF energy on the human common bile duct (CBD) and surrounding tissues has not been investigated. This pilot study aimed to determine the relationship between RF energy and the depth of ablation in the normal human CBD. METHODS: The study was performed on fresh ex vivo human biliary-pancreatic tissue which had been resected for a pancreatic cyst or mass. The study was conducted within 15 min after resection. A bipolar Habib RFA catheter was placed into the middle of the intact CBD, and three different (5, 7, 10 W) power settings were applied over a 90-s period by an RF generator. Gross and histological examinations were performed. The depth of coagulation necrosis in CBD and the effect of RFA on CBD wall and surrounding pancreas tissue were determined by microscopic examination. RESULTS: The study included eight tissue samples. 5 W power was applied to three sites and RFA caused only focal epithelial necrosis limited to the CBD mucosa. 7 and 10 W were applied to five sites and coagulation necrosis occurred in all cases. Microscopically, necrosis was transmural, involved accessory bile duct glands, and extended to the surrounding pancreatic tissue in four of these cases. Macroscopically, RFA resulted in circumferential white-yellowish color change extending approximately 2 cm of the CBD. CONCLUSION: Bipolar RF energy application with 5 W resulted in limited ablation on CBD wall. However, 7 and 10 W generated tissue necrosis which extended through the CBD wall and into surrounding pancreas tissue. Endoscopic biliary RFA is an effective technique for local biliary tissue ablation but the use of high energy may injure surrounding tissue.

3 Article Improved Detection of Circulating Epithelial Cells in Patients with Intraductal Papillary Mucinous Neoplasms. 2018

Franses, Joseph W / Basar, Omer / Kadayifci, Abdurrahman / Yuksel, Osman / Choz, Melissa / Kulkarni, Anupriya S / Tai, Eric / Vo, Kevin D / Arora, Kshitij S / Desai, Niyati / Licausi, Joseph A / Toner, Mehmet / Maheswaran, Shyamala / Haber, Daniel A / Ryan, David P / Brugge, William R / Ting, David T. ·Cancer Center, Massachusetts General Hospital, Boston, Massachusetts, USA. · Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. · Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA. · Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA. · Center for Engineering in Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. · Howard Hughes Medical Institute, Chevy Chase, Maryland, USA. · Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA brugge.william@mgh.harvard.edu dting1@mgh.harvard.edu. · Cancer Center, Massachusetts General Hospital, Boston, Massachusetts, USA brugge.william@mgh.harvard.edu dting1@mgh.harvard.edu. ·Oncologist · Pubmed #28860411.

ABSTRACT: BACKGROUND: Recent work has demonstrated early shedding of circulating epithelial cells (CECs) from premalignant intraductal papillary mucinous neoplasms (IPMNs). However, the potential use of CECs as a "liquid biopsy" for patients with IPMNs has been limited by antigen dependence of CEC isolation devices and the lack of robust detection biomarkers across CEC phenotypes. MATERIALS AND METHODS: We utilized a negative depletion microfluidic platform to purify CECs from contaminating leukocytes and coupled this platform with immunofluorescence, RNA in situ hybridization, and RNA sequencing (RNA-seq) detection and enumeration. RESULTS: Using established protein (EpCAM, cytokeratins) and novel noncoding RNA (HSATII, cytokeratins) biomarkers, we detected CECs in 88% of patients bearing IPMN lesions. RNA-seq analysis for MUC genes confirm the likely origin of these CECs from pancreatic lesions. CONCLUSION: Our findings increase the sensitivity of detection of these cells and therefore could have clinical implications for cancer risk stratification. IMPLICATIONS FOR PRACTICE: This work describes a high-sensitivity platform for detection of epithelial cells shed from preneoplastic lesions at high risk of malignant transformation. Further research efforts are underway to define the transcriptional programs that might allow discrimination between circulating cells released from tumors that will become malignant and cells released from tumors that will not. After further refinement, this combination of technologies could be deployed for monitoring and early detection of patients at high risk for developing new or recurrent pancreatic malignancies.

4 Article Needle-Based Confocal Laser Endomicroscopy for Evaluation of Cystic Neoplasms of the Pancreas. 2017

Kadayifci, Abdurrahman / Atar, Mustafa / Basar, Omer / Forcione, David G / Brugge, William R. ·Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, 3-H GI Associates, Zero Emerson Place, Blossom st., Boston, MA, 02114, USA. kadayifci@hotmail.com. · Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, 3-H GI Associates, Zero Emerson Place, Blossom st., Boston, MA, 02114, USA. ·Dig Dis Sci · Pubmed #28281172.

ABSTRACT: BACKGROUND: The accurate diagnosis of cystic neoplasms of the pancreas (CNP) with current diagnostic methods is limited. Endoscopic ultrasound (EUS)-guided needle-based confocal laser endomicroscopy (nCLE) is a new technique which can obtain images from the cyst wall during EUS-fine needle aspiration (EUS-FNA). The aim of this study was to assess the safety, feasibility, and diagnostic value of nCLE for CNP. METHODS: Patients who underwent EUS-FNA to evaluate a CNP larger than 2 cm were enrolled. The cyst was punctured with 19-G FNA needle preloaded with an nCLE probe. The images from different areas of the cyst wall were recorded. Using the final diagnosis defined by surgery or EUS-FNA cyst fluid analysis, the accuracy of the confocal images was defined. RESULTS: The procedure and image acquisition was successful in 18 of the 20 patients. Predefined typical structures for mucinous cysts were visualized in 8 of 12 (66%) cysts but none of the non-mucinous cysts. The superficial vascular network which is a typical finding of serous cysts was observed in 2 of 3 patients. The sensitivity, specificity, and diagnostic accuracy of the findings of epithelial structures by nCLE were 66, 100, and 80%, respectively, for a mucinous cyst diagnosis. All patients tolerated the procedure well, and no adverse effects were determined. CONCLUSION: nCLE was found to be safe and feasible with high technical success, in this pilot study. With an overall accuracy of 80%, it has the potential to contribute to the diagnosis of CNP with specific imaging.

5 Article Preoperative characteristics and cytological features of 136 histologically confirmed pancreatic mucinous cystic neoplasms. 2017

Scourtas, Aristana / Dudley, Jonathan C / Brugge, William R / Kadayifci, Abdurrahman / Mino-Kenudson, Mari / Pitman, Martha B. ·Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts. · Department of Pathology, Stanford University Medical Center, Palo Alto, California. · Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts. · Division of Gastroenterology, Gaziantep University School of Medicine, Gaziantep, Turkey. ·Cancer Cytopathol · Pubmed #27926784.

ABSTRACT: BACKGROUND: Mucinous cystic neoplasms (MCNs) of the pancreas present a management conundrum. The majority are benign but all are resected due to their malignant potential. Recent studies have recommended nonsurgical management. In the current study, the authors analyzed the preoperative imaging, cytology, and cyst fluid characteristics of 136 histologically confirmed MCNs to assess predictors of a high-risk (HR) cyst for surgical triage. METHODS: MCNs resected at the Massachusetts General Hospital between 1990 and 2014 formed the study cohort. Patient demographics, cyst size, and mural nodules (MNs) by endoscopic ultrasound, cytology, and cyst fluid carcinoembryonic antigen and amylase levels were correlated with histological grade. A HR cyst was defined as high-grade dysplasia or invasive carcinoma on histology. Performance characteristics were assessed for each parameter, with a cyst size ≥3 cm or a MN on imaging and malignant cytology considered to be "true-positive" results for predicting malignancy. RESULTS: Only 15 of the 136 cysts had HR histology (11%). On average, patients with HR cysts were older than those with low-risk cysts (55 years vs 49 years, respectively). High-grade cytology was the most accurate predictor of malignancy (95%) followed by MN and cyst size together (88%) and MN alone (83%). The average carcinoembryonic antigen level (in ng/mL) increased with the grade of dysplasia but the ranges overlapped between low risk and HR cysts. CONCLUSIONS: To the authors' knowledge, the current study is the largest series to date analyzing the cytological features of histologically confirmed MCN. Cytology is insensitive but very specific for detecting a HR MCN and outperformed imaging for the detection of HR MCN. Endoscopic ultrasound-guided fine-needle aspiration and cytology should be performed on any clinically suspected MCN that is being considered for conservative management. Cancer Cytopathol 2017;125:169-177. © 2016 American Cancer Society.

6 Article Value of adding GNAS testing to pancreatic cyst fluid KRAS and carcinoembryonic antigen analysis for the diagnosis of intraductal papillary mucinous neoplasms. 2017

Kadayifci, Abdurrahman / Atar, Mustafa / Wang, Jessica L / Forcione, David G / Casey, Brenna W / Pitman, Martha B / Brugge, William R. ·Division of Gastroenterology, Gaziantep University School of Medicine, Gaziantep, Turkey. · Division of Gastroenterology, Harvard Medical School, Boston, USA. · Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, USA. ·Dig Endosc · Pubmed #27514845.

ABSTRACT: BACKGROUND AND AIM: Molecular analysis of pancreatic cyst fluid (PCF) has been proposed as a novel method for differentiating pancreatic cystic lesions (PCL). The present study aimed to investigate the value of GNAS testing when added to KRAS and carcinoembryonic antigen (CEA) testing of PCF for the diagnosis of intraductal papillary mucinous neoplasms (IPMN). METHODS: Prospectively collected endoscopic ultrasonography fine-needle aspiration (EUS-FNA) data were analyzed retrospectively for GNAS and KRAS mutations and CEA results. IPMN were histologically confirmed or supported by imaging and EUS-FNA findings (KRAS, CEA, cytology). Performance characteristics of GNAS added to KRAS and CEA for the diagnosis of IPMN were calculated. RESULTS: The study population consisted of 197 patients with cyst fluid test results. Cysts were histologically classified in 33 patients and by clinical criteria in 164 patients. The IPMN group included 108 patients and the non-IPMN group included 89 patients. GNAS was positive in 51 patients (47.2%) with IPMN. Forty-two of these patients (82.3%) also had a KRAS mutation. Adding GNAS to KRAS increased the diagnostic accuracy from 76.6% to 79.1% (P > 0.05). Adding GNAS to CEA increased the diagnostic accuracy from 66.4% to 80.7 % (P < 0.05), but did not achieve a diagnostic superiority to KRAS testing alone (80.7% vs 76.6%, P > 0.05). The diagnostic accuracy of the triple combination was significantly better than all single tests (P < 0.05). CONCLUSION: GNAS mutation is a highly specific test for IPMN. When GNAS testing is added to CEA and KRAS, a significantly greater overall accuracy (86.2%) is achieved.

7 Article Impact of next-generation sequencing on the clinical diagnosis of pancreatic cysts. 2016

Jones, Martin / Zheng, Zongli / Wang, Jessica / Dudley, Jonathan / Albanese, Emily / Kadayifci, Abdurrahman / Dias-Santagata, Dora / Le, Long / Brugge, William R / Fernandez-del Castillo, Carlos / Mino-Kenudson, Mari / Iafrate, A John / Pitman, Martha B. ·Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. · Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. · Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. ·Gastrointest Endosc · Pubmed #26253016.

ABSTRACT: BACKGROUND AND AIMS: The value of next-generation sequencing (NGS) of pancreatic cyst fluid relative to the clinical and imaging impression has not been well-studied. The aim of this study was to assess the impact of NGS on the clinical diagnosis from imaging and carcinoembryonic antigen (CEA) and thus the management of pancreatic cysts. METHODS: Ninety-two pancreatic cyst fluids from 86 patients were analyzed by cytology, CEA, and targeted NGS. Cysts were classified by imaging as nonmucinous, mucinous, or not specified. NGS results were compared with the imaging impression stratified by CEA and cytology. RESULTS: NGS impacted the clinical diagnosis by defining a cyst as mucinous in 48% of cysts without elevated CEA levels. The VHL gene in 2 intraductal papillary mucinous neoplasms (IPMNs) supported a serous cystadenoma. Twenty percent of cysts that were nonmucinous by imaging were mucinous by NGS. Of the 14 not-specific cysts, CEA levels were not elevated in 12 (86%), and NGS established a mucinous etiology in 3 (25%). A KRAS or GNAS mutation supported an IPMN with nonmucinous CEA in 71%. A KRAS mutation reclassified 19% of nonneoplastic cysts with nonmucinous CEA as mucinous. Seven cyst fluids (8%) had either a TP53 mutation or loss of CDKN2A or SMAD4 in addition to KRAS and/or GNAS mutations; 5 of 7 (71%) were clinically malignant, and high-grade cytology was detected in all 5. Overall, CEA was more specific for a mucinous etiology (100%), but NGS was more sensitive (86% vs 57%). CONCLUSIONS: NGS of pancreatic cyst fluid impacts clinical diagnosis and patient management by defining, supporting, or changing the clinical diagnosis based on imaging and CEA. NGS was most valuable in identifying mucinous cysts with nonmucinous CEA. An added benefit is the potential to detect mutations late in the progression to malignancy that may increase the risk classification of the cyst based on imaging and cytology.

8 Minor Endoscopic ultrasound-guided fine-needle aspiration for the differential diagnosis of intraductal papillary mucinous neoplasms and size stratification for surveillance. 2014

Kadayifci, Abdurrahman / Brugge, William R. · ·Endoscopy · Pubmed #24671860.

ABSTRACT: -- No abstract --