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Fluorescence in situ hybridization compared with conventional cytology for the diagnosis of malignant biliary tract strictures in Asian patients.
- Source :
-
Gastrointestinal endoscopy [Gastrointest Endosc] 2016 Jun; Vol. 83 (6), pp. 1228-35. Date of Electronic Publication: 2015 Dec 10. - Publication Year :
- 2016
-
Abstract
- Background and Aims: Fluorescence in situ hybridization (FISH) has improved the diagnostic performance of cytology for the evaluation of malignant biliary strictures in the United States and Europe. The utility of FISH for the diagnosis of biliary strictures in Asia is currently unknown. We aimed to compare the sensitivity of FISH and conventional cytology for the diagnosis of malignant biliary strictures in Thai patients.<br />Methods: A prospective study was performed at 2 university hospitals between 2010 and 2013. Patients being evaluated for malignant-appearing biliary strictures were included (N = 99). Bile duct brushings were collected and assessed by cytology and FISH. Sensitivities with 95% confidence intervals of cytology and FISH were the main outcome measures.<br />Results: The overall sensitivities of cytology and FISH were 38% and 55%, respectively (P = .001). For those with a diagnosis of cancer based on clinical evidence without biopsy confirmation (n = 44), the sensitivities of cytology and FISH were 43% and 57%, respectively (P = .06). For the 49 patients for whom a cancer diagnosis was confirmed by pathology, FISH had a significantly higher sensitivity than cytology, with a sensitivity of 53% versus 33%, respectively (P = .008).<br />Conclusions: FISH improves the diagnostic performance of cytology and can be used as a complementary tool to bile duct brushing and biopsy for the evaluation of malignancy in biliary strictures in Asian populations.<br /> (Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Ampulla of Vater pathology
Asian People
Bile Duct Neoplasms complications
Bile Duct Neoplasms genetics
Bile Duct Neoplasms pathology
Biopsy
CA-19-9 Antigen metabolism
Carcinoembryonic Antigen metabolism
Cholangiocarcinoma complications
Cholangiocarcinoma genetics
Cholangiocarcinoma pathology
Common Bile Duct Neoplasms complications
Common Bile Duct Neoplasms diagnosis
Common Bile Duct Neoplasms genetics
Common Bile Duct Neoplasms pathology
Constriction, Pathologic etiology
Female
Gallbladder Neoplasms complications
Gallbladder Neoplasms genetics
Gallbladder Neoplasms pathology
Humans
Male
Middle Aged
Pancreatic Neoplasms complications
Pancreatic Neoplasms genetics
Pancreatic Neoplasms pathology
Prospective Studies
Bile Duct Diseases etiology
Bile Duct Neoplasms diagnosis
Cholangiocarcinoma diagnosis
Cytodiagnosis
Gallbladder Neoplasms diagnosis
In Situ Hybridization, Fluorescence
Pancreatic Neoplasms diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6779
- Volume :
- 83
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Gastrointestinal endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 26684604
- Full Text :
- https://doi.org/10.1016/j.gie.2015.11.037