PMID- 22326996
OWN - NLM
STAT- MEDLINE
DCOM- 20120618
LR  - 20220409
IS  - 1528-0012 (Electronic)
IS  - 0016-5085 (Linking)
VI  - 142
IP  - 5
DP  - 2012 May
TI  - Comparison of methods to detect neoplasia in patients undergoing endoscopic 
      ultrasound-guided fine-needle aspiration.
PG  - 1112-1121.e2
LID - 10.1053/j.gastro.2012.02.002 [doi]
AB  - BACKGROUND & AIMS: Digital image analysis (DIA) and fluorescence in situ 
      hybridization (FISH) can be used to evaluate biliary strictures with greater 
      accuracy than conventional cytology (CC). We performed a prospective evaluation 
      of the accuracy of CC, compared with that of DIA and FISH, in detection of 
      malignancy in patients undergoing endoscopic ultrasonography (EUS) fine-needle 
      aspiration (FNA). METHODS: We collected a minimum of 6 FNA samples from each of 
      250 patients during EUS. CC or DIA and FISH analyses were performed on every 
      other specimen (from every other FNA pass); patients were randomly assigned to 
      the first test performed. CC slides were reviewed by gastrointestinal 
      cytopathologists who were blinded to all data. Findings from cytohistologic 
      analysis, after a minimum 24-month follow-up period, were used as the standard (n 
      = 202; median age, 65 years). RESULTS: Aspirates were collected from lymph nodes 
      (n = 111), pancreas (n = 61), gastrointestinal lumen wall (n = 9), periluminal 
      mass (n = 4), liver (n = 8), and miscellaneous sites (n = 9). Matched samples 
      provided a mean of 3.2 passes for CC and 1.6 passes for DIA and FISH. The data 
      indicate a potential lack of utility for DIA. The combination of CC and FISH 
      detected malignancy with 11% greater sensitivity than CC alone (P = .0002), but 
      specificity was reduced from 100% to 96%. CONCLUSIONS: FISH analysis identifies 
      neoplastic lesions with significantly greater sensitivity than CC in patients 
      with diverse pathologies who underwent EUS with FNA, despite limited tissue 
      sampling for FISH analysis.
CI  - Copyright (c) 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.
FAU - Levy, Michael J
AU  - Levy MJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 
      55905, USA. levy.michael@mayo.edu
FAU - Oberg, Trynda N
AU  - Oberg TN
FAU - Campion, Michael B
AU  - Campion MB
FAU - Clayton, Amy C
AU  - Clayton AC
FAU - Halling, Kevin C
AU  - Halling KC
FAU - Henry, Michael R
AU  - Henry MR
FAU - Kipp, Benjamin R
AU  - Kipp BR
FAU - Sebo, Thomas J
AU  - Sebo TJ
FAU - Zhang, Jun
AU  - Zhang J
FAU - Enders, Felicity T
AU  - Enders FT
FAU - Clain, Jonathan E
AU  - Clain JE
FAU - Gleeson, Ferga C
AU  - Gleeson FC
FAU - Rajan, Elizabeth
AU  - Rajan E
FAU - Roberts, Lewis R
AU  - Roberts LR
FAU - Topazian, Mark D
AU  - Topazian MD
FAU - Wang, Kenneth K
AU  - Wang KK
FAU - Gores, Gregory J
AU  - Gores GJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120207
PL  - United States
TA  - Gastroenterology
JT  - Gastroenterology
JID - 0374630
SB  - IM
CIN - Gastroenterology. 2012 May;142(5):1055-7. PMID: 22446080
MH  - Adenocarcinoma/diagnosis/pathology
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biopsy, Fine-Needle/*methods
MH  - *Endosonography
MH  - Female
MH  - Humans
MH  - Image Processing, Computer-Assisted
MH  - In Situ Hybridization, Fluorescence
MH  - Male
MH  - Middle Aged
MH  - Neoplasms/*diagnosis/pathology
MH  - Prospective Studies
EDAT- 2012/02/14 06:00
MHDA- 2012/06/19 06:00
CRDT- 2012/02/14 06:00
PHST- 2011/09/30 00:00 [received]
PHST- 2012/01/25 00:00 [revised]
PHST- 2012/02/01 00:00 [accepted]
PHST- 2012/02/14 06:00 [entrez]
PHST- 2012/02/14 06:00 [pubmed]
PHST- 2012/06/19 06:00 [medline]
AID - S0016-5085(12)00157-6 [pii]
AID - 10.1053/j.gastro.2012.02.002 [doi]
PST - ppublish
SO  - Gastroenterology. 2012 May;142(5):1112-1121.e2. doi: 
      10.1053/j.gastro.2012.02.002. Epub 2012 Feb 7.