PMID- 22893461
OWN - NLM
STAT- MEDLINE
DCOM- 20130116
LR  - 20220318
IS  - 1499-3872 (Print)
VI  - 11
IP  - 4
DP  - 2012 Aug 15
TI  - Modern diagnostic approaches to cholangiocarcinoma.
PG  - 349-59
AB  - BACKGROUND: Cholangiocarcinoma is a very aggressive tumor with poor survival. 
      Therefore, early diagnosis and surgical resection are of paramount importance. 
      Its diagnosis is difficult because access to the tumor is not easy. Biopsy is 
      possible only for intrahepatic cholangiocarcinoma, which accounts for 10% of 
      cases. Routine brush cytology from endoscopic retrograde cholangiopancreatography 
      (ERCP) has a high specificity of 100% but unfortunately a low sensitivity of 30%. 
      In this review we briefly describe new diagnostic techniques applicable to ERCP 
      brush cytology specimens and targeting the genetic background of the disease, in 
      particular fluorescence in situ hybridization (FISH) and digital image analysis 
      (DIA). DATA SOURCES: The PubMed database up to 2011 was used for the retrieval of 
      relevant articles. The search terms FISH, fluorescence in situ hybridization, 
      DIA, digital image analysis and cholangiocarcinoma were used. Both original and 
      review articles were used. RESULTS: FISH identifies cells with chromosomal 
      abnormalities, mainly numerical aberrations, using a mixture of 
      fluorescence-labeled probes. FISH offers a higher sensitivity than routine 
      cytology, retaining a high level of specificity. The DIA criterion for malignancy 
      is demonstration of aneuploidy. This technique increases the sensitivity to 40%, 
      but the specificity remains low. Preliminary data from application to other 
      tumors suggest that combination of FISH and DIA may be of further benefit. 
      CONCLUSIONS: The new techniques offer a significantly enhanced diagnostic 
      efficacy in the evaluation of ERCP brush specimens. Apart from contributing to a 
      more timely diagnosis, their wider application to cholangiocarcinoma may also 
      facilitate the genetic study of the disease and add to our understanding of 
      oncogenesis at the molecular level, with the prospect of identifying targets for 
      novel therapeutic interventions.
FAU - Vasilieva, Larisa E
AU  - Vasilieva LE
AD  - Second Department of Internal Medicine, University of Athens Medical School, 
      Hippokration General Hospital, 114 Vas Sofias Avenue, Athens 11527, Greece. 
      larisatheo@yahoo.gr
FAU - Papadhimitriou, Stefanos I
AU  - Papadhimitriou SI
FAU - Dourakis, Spyros P
AU  - Dourakis SP
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Singapore
TA  - Hepatobiliary Pancreat Dis Int
JT  - Hepatobiliary & pancreatic diseases international : HBPD INT
JID - 101151457
SB  - IM
MH  - Algorithms
MH  - Bile Duct Neoplasms/*diagnosis/genetics/pathology
MH  - Bile Ducts, Intrahepatic/*pathology
MH  - Biopsy
MH  - Cholangiocarcinoma/*diagnosis/genetics/pathology
MH  - Cholangiopancreatography, Endoscopic Retrograde
MH  - *Chromosome Aberrations
MH  - Humans
MH  - Image Interpretation, Computer-Assisted
MH  - In Situ Hybridization, Fluorescence
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Sensitivity and Specificity
EDAT- 2012/08/16 06:00
MHDA- 2013/01/17 06:00
CRDT- 2012/08/16 06:00
PHST- 2012/08/16 06:00 [entrez]
PHST- 2012/08/16 06:00 [pubmed]
PHST- 2013/01/17 06:00 [medline]
AID - S1499-3872(12)60192-1 [pii]
AID - 10.1016/s1499-3872(12)60192-1 [doi]
PST - ppublish
SO  - Hepatobiliary Pancreat Dis Int. 2012 Aug 15;11(4):349-59. doi: 
      10.1016/s1499-3872(12)60192-1.