Background
Recent advances in global gene profiling have enabled a greater understanding of the pathogenesis of pancreas cancer and identified putative diagnostic molecular markers. However, we need to transform these advances into clinical practice to modify the outcome of the disease. Aim: To explore the feasibility of gene expression profiling from RNA isolated from pancreatic ductal juice and test the hypothesis that the detection of gene signatures, measured by globally amplified poly(A) cDNA in ductal juice will provide a high degree of correlation with the same genes from matched intra-operative tumour samples, from patients with pancreatic cancer.

Materials and Methods
Intraoperative sampling of pancreatic juice and collection of matched tissue samples was undertaken in patients undergoing pancreaticoduodenectomy for pancreas cancer. RNA was isolated and Poly(A) PCR was used to globally amplify the RNA. RT-PCR was used to measure expression levels of 18 genes (selected from microarray studies). Spearman’s rank correlation test was used to examine the relationship of gene expression between pancreatic juice and tissue.

Results
Only one gene out of eighteen, MSLN, showed significant correlation in the expression levels between paired pancreatic juice and tissue samples in pancreas cancer. MSLN is a gene that plays a role in cell adhesion and has been demonstrated to be over-expressed in pancreas cancer.

Conclusion
RNA analysis of pancreatic juice is feasible using the Poly(A) cDNA technique and correlation of gene expression is shown to exist, albeit with low sensitivity, indicating its potential use in clinical practice with small tissue and juice samples.