PMID- 17030177
OWN - NLM
STAT- MEDLINE
DCOM- 20061204
LR  - 20220409
IS  - 0016-5085 (Print)
IS  - 1528-0012 (Electronic)
IS  - 0016-5085 (Linking)
VI  - 131
IP  - 4
DP  - 2006 Oct
TI  - Advanced cytologic techniques for the detection of malignant pancreatobiliary 
      strictures.
PG  - 1064-72
AB  - BACKGROUND & AIMS: Two advanced cytologic techniques for detecting 
      aneuploidy-digital image analysis (DIA) and fluorescence in situ hybridization 
      (FISH)-have recently been developed to help identify malignant pancreatobiliary 
      strictures. The aim of this study was to assess the clinical utility of cytology, 
      DIA, and FISH for the identification of malignant pancreatobiliary strictures. 
      METHODS: Brush cytologic specimens from 233 consecutive patients undergoing 
      endoscopic retrograde cholangiopancreatography for pancreatobiliary strictures 
      were examined by all 3 (cytology, DIA, and FISH) techniques. Strictures were 
      stratified as proximal (n = 33) or distal (n = 114) based on whether they 
      occurred above or below the cystic duct, respectively. Strictures in patients 
      with primary sclerosing cholangitis (n = 86) were analyzed separately. RESULTS: 
      Despite the stratification, the performances of the tests were similar. 
      Conventional cytology has a low sensitivity (4%-20%) but 100% specificity. 
      Because of the high specificity for cytology, we assessed the performance of the 
      other tests when conventional cytology was negative. In this clinical context, 
      FISH had an increased sensitivity (35%-60%) when assessing for chromosomal gains 
      (polysomy) while preserving the specificity of cytology. The sensitivity and 
      specificity of DIA was intermediate as compared with routine cytology and FISH 
      but was additive to FISH values demonstrating only trisomy of chromosome 7 or 
      chromosome 3. CONCLUSIONS: These findings suggest that FISH and DIA increase the 
      sensitivity for the diagnosis of malignant pancreatobiliary tract strictures over 
      that obtained by conventional cytology while maintaining an acceptable 
      specificity.
FAU - Moreno Luna, Laura E
AU  - Moreno Luna LE
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 
      First Street SW, Rochester, MN 55905, USA.
FAU - Kipp, Benjamin
AU  - Kipp B
FAU - Halling, Kevin C
AU  - Halling KC
FAU - Sebo, Thomas J
AU  - Sebo TJ
FAU - Kremers, Walter K
AU  - Kremers WK
FAU - Roberts, Lewis R
AU  - Roberts LR
FAU - Barr Fritcher, Emily G
AU  - Barr Fritcher EG
FAU - Levy, Michael J
AU  - Levy MJ
FAU - Gores, Gregory J
AU  - Gores GJ
LA  - eng
GR  - R01 DK059427/DK/NIDDK NIH HHS/United States
GR  - NIH 59427/PHS HHS/United States
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20060816
PL  - United States
TA  - Gastroenterology
JT  - Gastroenterology
JID - 0374630
RN  - 0 (DNA, Neoplasm)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Aneuploidy
MH  - Child
MH  - *Cholangiopancreatography, Endoscopic Retrograde
MH  - Cholestasis, Extrahepatic/etiology/*pathology
MH  - Constriction, Pathologic
MH  - DNA, Neoplasm/analysis
MH  - Decision Trees
MH  - Diagnosis, Computer-Assisted
MH  - Female
MH  - Humans
MH  - In Situ Hybridization, Fluorescence/instrumentation/*methods
MH  - Male
MH  - Middle Aged
MH  - Pancreatic Neoplasms/complications/*pathology
MH  - Predictive Value of Tests
MH  - Sensitivity and Specificity
PMC - PMC1769444
MID - NIHMS14109
EDAT- 2006/10/13 09:00
MHDA- 2006/12/09 09:00
PMCR- 2008/01/30
CRDT- 2006/10/13 09:00
PHST- 2006/04/06 00:00 [received]
PHST- 2006/07/05 00:00 [accepted]
PHST- 2006/10/13 09:00 [pubmed]
PHST- 2006/12/09 09:00 [medline]
PHST- 2006/10/13 09:00 [entrez]
PHST- 2008/01/30 00:00 [pmc-release]
AID - S0016-5085(06)01760-4 [pii]
AID - 10.1053/j.gastro.2006.08.021 [doi]
PST - ppublish
SO  - Gastroenterology. 2006 Oct;131(4):1064-72. doi: 10.1053/j.gastro.2006.08.021. 
      Epub 2006 Aug 16.