Routine brush cytology and fluorescence in situ hybridization for assessment of pancreatobiliary strictures

Smoczyński, Marian; Jabłońska, Anna; Matyskiel, Anita; Lakomy, Joanna; Dubowik, Michał; Marek, Iwona; Biernat, Wojciech; Limon, Janusz

doi:10.1016/j.gie.2011.08.040

Cited by 66 publications

(47 citation statements)

References 27 publications

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“…In particular, fluorescent in situ hybridization (FISH) has attracted significant interest as it can confer an additive benefit of 10–25% increased sensitivity for the detection of bile duct cancer [16,17,18,19]. FISH is usually performed on bile duct brushing cytology slides using a small panel of marker probes optimized for the detection of urinary bladder cancer [16,17,18,19]. The technique is robust, though in clinical practice it shares the same limitation of low cellularity and sampling variation that hinders cytology evaluation.…”

Section: Discussionmentioning

confidence: 99%

Molecular Analysis of Centrifugation Supernatant Fluid from Pancreaticobiliary Duct Samples Can Improve Cancer Detection

Finkelstein¹,

Bibbo

Loren

et al. 2012

Acta Cytologica

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Objective: We aimed to supplement microscopic examination of biliary cytobrush specimens to improve sensitivity by mutational profiling of: (1) selected cells microdissected from cytology slides and (2) corresponding cell-free DNA in residual supernatant fluid. Study Design: From 43 patients with brushings of bile or pancreatic duct strictures, DNA was extracted from microdissected cells and 1–2 ml of cytocentrifugation supernatant fluid. Mutational analysis targeted 17 genomic sites associated with pancreaticobiliary cancer, including sequencing for KRAS point mutation and loss of heterozygosity (LOH) analysis of microsatellites located at 1p, 3p, 5q, 9p, 10q, 17p, 17q, 21q, and 22q. Results: Mutations were found in 25/28 patients with malignancy, and no mutations were found in 5/5 patients with benign surgical results. The cell-free supernatant fluid generally contained higher levels and quality of DNA, resulting in increased detection of mutations in most patients. KRAS mutations only occurred in patients with pancreatic cancer. Mutational profiling of supernatant fluid specimens resulted in high sensitivity and specificity for malignancy, improving the detection of malignancy over cytology alone. Conclusion: Brush cytology specimens yielded supernatant fluid enriched with DNA, probably from actively proliferating cells. Mutational profiling can enhance the cytologic evaluation and characterization of specimens suspected to contain pancreatic or bile duct cancer.

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Section: Discussionmentioning

confidence: 99%

Molecular Analysis of Centrifugation Supernatant Fluid from Pancreaticobiliary Duct Samples Can Improve Cancer Detection

Finkelstein¹,

Bibbo

Loren

et al. 2012

Acta Cytologica

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“…When the presence of 9p21 deletion was included as a positive FISH result, the sensitivity of FISH increased to 98%. Smoczynski et al evaluated 81 patients with pancreatobiliary tract strictures and reported that FISH increased the sensitivity of cytology testing from 35% to 52% with a specificity of 89% . The sensitivity of FISH was highest in a study by Boldorini et al, who reported a value of 90% .…”

Section: Introductionmentioning

confidence: 99%

Improving the accuracy of pancreatobiliary tract cytology with fluorescence in situ hybridization

Kipp

Fritcher

Pettengill

et al. 2013

Cancer Cytopathology

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The detection of aneuploidy by fluorescence in situ hybridization (FISH) has revolutionized how laboratories diagnose cholangiocarcinoma and pancreatic adenocarcinoma using cytology specimens. Numerous clinical studies have demonstrated that FISH increases the diagnostic sensitivity of routine cytology for detecting pancreatobiliary tract malignancy with minimal decreases in clinical specificity. FISH also provides useful information in difficult clinical scenarios, including the assessment of patients with biliary strictures who have equivocal cytology results and the assessment of patients with primary sclerosing cholangitis who have clinical features suggestive of malignancy. The improved ability to detect pancreatobiliary tract cancers offers the possibility of earlier detection when patients are amenable to surgical intervention and can decrease health care costs by reducing the amount of clinical evaluation required to arrive at a cancer diagnosis. Cytopathology personnel should maintain familiarity with molecular cytology testing methodologies, because morphologic and aneuploidy assessment of tumors will continue to be an integral part of large-scale genome analyses of individual tumors.

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“…Low cellular yields are considered as the primary reason for the low sensitivity of brush cytology. Hence, various techniques have been employed to improve the sensitivity of biliary lesion diagnosis, including fluorescence in situ hybridization [4], increasing cellular yield via application of a new brush type [5,6], a new cell block technique [7], and a pre-dilation technique to disrupt strictures [8].…”

Section: Introductionmentioning

confidence: 99%

Utility of lavage cytology plus targeted biopsy during cholangioscopy for the diagnosis of indeterminate biliary lesions

Motomura¹,

Akahoshi²,

Kawakami³

et al. 2017

Gastroenterol Hepatol Endosc

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Routine brush cytology and fluorescence in situ hybridization for assessment of pancreatobiliary strictures

Cited by 66 publications

References 27 publications

Molecular Analysis of Centrifugation Supernatant Fluid from Pancreaticobiliary Duct Samples Can Improve Cancer Detection

Molecular Analysis of Centrifugation Supernatant Fluid from Pancreaticobiliary Duct Samples Can Improve Cancer Detection

Improving the accuracy of pancreatobiliary tract cytology with fluorescence in situ hybridization

Utility of lavage cytology plus targeted biopsy during cholangioscopy for the diagnosis of indeterminate biliary lesions

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