PMID- 17725938
OWN - NLM
STAT- MEDLINE
DCOM- 20071206
LR  - 20220409
IS  - 0016-5107 (Print)
IS  - 0016-5107 (Linking)
VI  - 66
IP  - 3
DP  - 2007 Sep
TI  - Preliminary experience comparing routine cytology results with the composite 
      results of digital image analysis and fluorescence in situ hybridization in 
      patients undergoing EUS-guided FNA.
PG  - 483-90
AB  - BACKGROUND: Studies indicate enhanced diagnostic accuracy for digital image 
      analysis (DIA) and fluorescence in situ hybridization (FISH) versus routine 
      cytology examination (RC) when biliary strictures are evaluated. These tumor 
      markers have not been applied to EUS-guided FNA. OBJECTIVE: Our purpose was to 
      determine the accuracy of RC versus the composite results of DIA/FISH. DESIGN: 
      Patients enrolled with known or suspected malignancy. The final diagnosis was 
      based on strict cytopathologic and imaging criteria and 12-month follow-up. 
      SETTINGS: Tertiary referral center. PATIENTS: A total of 39 patients were 
      enrolled in whom each diagnostic test was performed on samples from 42 sites to 
      evaluate lymphadenopathy (n=19), pancreatic mass (n=19), esophageal or gastric 
      wall mass (n=3), and thyroid mass (n=1). INTERVENTIONS: EUS-guided FNA with RC, 
      DIA, and FISH. MAIN OUTCOME MEASUREMENT: Diagnostic accuracy of RC, DIA, and 
      FISH. RESULTS: Malignancy was diagnosed in 30 of 42 patients, including 
      esophageal squamous cell carcinoma, esophageal adenocarcinoma, gastric 
      adenocarcinoma, pancreatic adenocarcinoma, pancreatic mucinous cystic neoplasia, 
      intraductal papillary mucinous neoplasia, metastatic forearm sarcoma, small cell 
      and non-small cell lung cancer, thyroid carcinoma, malignant GI stromal tumor, 
      melanoma, adenocarcinoma of unknown primary, and lymphoma. The sensitivity, 
      specificity, and accuracy of DIA/FISH versus RC for detecting malignancy were 
      97%, 100%, and 98% versus 87%, 100%, and 90%, respectively. LIMITATIONS: 
      Single-center pilot study. CONCLUSIONS: Our findings suggest that DIA and FISH 
      processing of EUS-guided FNA specimens provides higher diagnostic accuracy than 
      RC does. These data suggest that these tumor markers incorporate generic targets 
      as suggested by the high diagnostic sensitivity in this patient cohort with 
      diverse pathologic conditions.
FAU - Levy, Michael J
AU  - Levy MJ
AD  - Division of Gastroenterology and Hepatology, Department of Pathology, Mayo Clinic 
      College of Medicine, Rochester, Minnesota 55905, USA.
FAU - Clain, Jonathan E
AU  - Clain JE
FAU - Clayton, Amy
AU  - Clayton A
FAU - Halling, Kevin C
AU  - Halling KC
FAU - Kipp, Benjamin R
AU  - Kipp BR
FAU - Rajan, Elizabeth
AU  - Rajan E
FAU - Roberts, Lewis R
AU  - Roberts LR
FAU - Root, Renee M
AU  - Root RM
FAU - Sebo, Thomas J
AU  - Sebo TJ
FAU - Topazian, Mark D
AU  - Topazian MD
FAU - Wang, Kenneth K
AU  - Wang KK
FAU - Wiersema, Maurits J
AU  - Wiersema MJ
FAU - Gores, Gregory J
AU  - Gores GJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Biopsy, Fine-Needle
MH  - Cohort Studies
MH  - *Endosonography
MH  - Esophageal Neoplasms/*pathology
MH  - Esophagus/pathology
MH  - Female
MH  - Humans
MH  - *Image Processing, Computer-Assisted
MH  - *In Situ Hybridization, Fluorescence
MH  - Lymph Nodes/pathology
MH  - Lymphatic Metastasis/*pathology
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Invasiveness/pathology
MH  - Neoplasm Staging
MH  - Pancreas/pathology
MH  - Pancreatic Neoplasms/*pathology
MH  - Pilot Projects
MH  - Sensitivity and Specificity
MH  - Stomach/pathology
MH  - Stomach Neoplasms/*pathology
MH  - Thyroid Neoplasms/*pathology
EDAT- 2007/08/30 09:00
MHDA- 2007/12/07 09:00
CRDT- 2007/08/30 09:00
PHST- 2007/01/11 00:00 [received]
PHST- 2007/03/19 00:00 [accepted]
PHST- 2007/08/30 09:00 [pubmed]
PHST- 2007/12/07 09:00 [medline]
PHST- 2007/08/30 09:00 [entrez]
AID - S0016-5107(07)01596-9 [pii]
AID - 10.1016/j.gie.2007.03.1053 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2007 Sep;66(3):483-90. doi: 10.1016/j.gie.2007.03.1053.