Patients and specimens

Pancreatic juice samples for this study were obtained from participants enrolled in the CAPS studies (http://clinicaltrials.gov, {"type":"clinical-trial","attrs":{"text":"NCT00438906","term_id":"NCT00438906"}}NCT00438906, {"type":"clinical-trial","attrs":{"text":"NCT00714701","term_id":"NCT00714701"}}NCT00714701 and {"type":"clinical-trial","attrs":{"text":"NCT02000089","term_id":"NCT02000089"}}NCT02000089).^{2 4} One hundred and fifteen prospectively enrolled subjects (53 discovery, 62 validation), were included to represent a variety of diagnostic possibilities (see online supplementary table S1). Patient groups included those diagnosed with (1) PDAC (n=34), including selected patients who developed pancreatic cancer while under surveillance (n=4), (2) IPMN (n=57), diagnosed by surgical pathology or imaging findings, including cases undergoing pancreatic screening, or (3) controls (n=24) with normal pancreata undergoing EUS for other indications, or chronic pancreatitis. Archived primary pancreatic cancer or IPMN tissue was sequenced from some patients to compare mutations detected in juice samples with those present in tumours.

gutjnl-2015-311166supp002.pdf

Pancreatic juice secretion was stimulated by infusing human synthetic secretin (ChiRhoClin)(0.2 µg/kg intravenously over a minute). Juice was collected from the duodenal lumen for ∼5 min (typically, 5–10 mL).¹³ In addition, several samples of pancreatic cyst fluid aspirated during EUS were sequenced.²²

All elements of this study were approved by the Johns Hopkins institutional review board, and written informed consent was obtained from all patients.