Endoscopic retrograde brush cytology

Venu, Rama P.; Geenen, Joseph E.; Kini, Mukund; Hogan, Walter J.; Payne, M. Anthony; Johnson, G. K.; Schmalz, Michael J.

doi:10.1016/0016-5085(90)91178-9

Cited by 98 publications

(28 citation statements)

References 20 publications

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“…Brushing for cytologic examination from biliary or pancreatic strictures during ERCP is frequently performed with a diagnostic yield ranging from 30% to 57%. [9][10][11][12][13][14][15] These relatively poor yield rates are related to inadequate cellular acquisition during a single brushing, 16 which can be improved slightly by performing multiple brushing, 16 endobiliary biopsy forceps, and/or endoscopic needle aspiration. 17 The diagnostic yield remains less than 70% with a low negative predictive value, even when all 3 techniques are combined.…”

mentioning

confidence: 99%

Cholangioscopy and pancreatoscopy (with videos)

Nguyen

Binmoeller²,

Shah³

2009

Gastrointestinal Endoscopy

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mentioning

confidence: 99%

Cholangioscopy and pancreatoscopy (with videos)

Nguyen

Binmoeller²,

Shah³

2009

Gastrointestinal Endoscopy

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“…Retrograde pancreatography by a duodenoscope for the first time offered the opportunity to obtain directly ductal juice and to achieve tissue diagnosis in pancreatic disease in a minimal invasive manner (Endo et al, 1974;Hatfield et al, 1976). A multitude of studies have demonstrated that the joint application of endoscopy and cytotechniques has the capability to contribute to an improved clinical management (Tatsuta et al, 1983;Venu et al, 1990;Ryan, 1991;Nakaizumi et al, 1995;Enayati et al, 1996). However, while being characterised by a near 100% specificity, the sensitivity of pancreatic juice cytology proved to be unsatisfying because of an often low cell count or cell disintegration (Ferrari et al, 1994).…”

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confidence: 99%

Methylation status of p14ARF and p16INK4a as detected in pancreatic secretions

Klump¹,

Hsieh²,

Nehls³

et al. 2003

Br J Cancer

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The clinical management of pancreatic disease is often hampered by a lack of tissue diagnosis. Endoscopic pancreatography offers the opportunity to investigate exfoliated cells. However, the significance of mere cytological investigation is compromised by an insufficient sensitivity. The evaluation of the molecular background of carcinogenesis hopefully is capable of providing more sensitive diagnostic markers. The p16INK4a-/retinoblastoma tumour-suppressive pathway has been shown to be involved in the development of near to all pancreatic neoplasms. p14ARF is another tumour suppressor located in the immediate neighbourhood of p16INK4a. Promoter methylation has been demonstrated to be a major inactivating mechanism of both genes. We sought to further evaluate the role of the gene locus INK4a methylation status in the endoscopic differentiation of chronic inflammatory and neoplastic pancreatic disease. Pancreatic fluid specimens of 61 patients with either pancreatic carcinoma (PCA: 39), chronic pancreatitis (CP: 16) or a normal pancreatogram (NAD: 6) were retrieved. In order to detect methylation of either the p14ARF or the p16INK4a promoter a methylation-specific PCR protocol was applied. While 19 out of 39 patients with PCA showed p16 promoter methylation (49%), none of the 16 patients with CP revealed p16 promoter methylation. p14ARF methylation was found in a lower percentage of PCA specimens and in none of the samples of patients with CP. These results suggest a specific significance of INK4a for the development of malignant pancreatic disease. Our data further indicate a potential role for INK4a methylation as a diagnostic marker in the endoscopic differentiation of benign and malignant pancreatic disease.

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“…In two other reports, the authors used a new cytology brush that yielded a diagnostic sensitivity of 50% (Scudera et al, 1990) and 70%, respectively. However, despite the low yield, the authors reported a specificity of 100% in both series (Scudera et al, 1990;Venu et al, 1990).…”

Section: Discussionmentioning

confidence: 86%

Stent Scraping for Histology: An Alternative Method for Obtaining Tissue to Rule out Neoplasia

Siegel

Veerappan

Prudente

et al. 1994

Diagnostic and Therapeutic Endoscopy

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Despite improvement in diagnostic modalities, confirmation of a histologic diagnosis of cancer of the biliary tree and pancreas remains elusive. Attempts to collect positive cytology specimens from vigorous brushings or washings obtained at endoscopy or percutaneously are often unsuccessful. In our unit, we have increased the yield by obtaining tissue scraped from prostheses that have been previously placed in either the bile duct or the pancreatic duct. The stents are first flushed with saline to collect cytology specimens, after which, they are bisected and scraped, and these contents are prepared in a manner similar to that used to prepare biopsy samples. Twelve of 16 scraped samples, 9 bile duct and 3 pancreas, were positive for adenocarcinoma. The cytology specimens were positive in only 4 of the 12. We recommend this method of sampling from material contained within prostheses as an adjunct when previous brushings, washings, or biopsies are negative.

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Endoscopic retrograde brush cytology

Cited by 98 publications

References 20 publications

Cholangioscopy and pancreatoscopy (with videos)

Cholangioscopy and pancreatoscopy (with videos)

Methylation status of p14ARF and p16INK4a as detected in pancreatic secretions

Stent Scraping for Histology: An Alternative Method for Obtaining Tissue to Rule out Neoplasia

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