PMID- 34871554
OWN - NLM
STAT- MEDLINE
DCOM- 20220425
LR  - 20220715
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 95
IP  - 5
DP  - 2022 May
TI  - Impact of trimodality sampling on detection of malignant biliary strictures 
      compared with patients with primary sclerosing cholangitis.
PG  - 884-892
LID - S0016-5107(21)01848-4 [pii]
LID - 10.1016/j.gie.2021.11.029 [doi]
AB  - BACKGROUND AND AIMS: Malignant biliary strictures can be difficult to diagnose, 
      with up to 20% considered indeterminate after initial tissue sampling. This study 
      aimed to determine the performance characteristics of transpapillary biopsy 
      sampling (TPB) and fluorescence in situ hybridization (FISH) in isolation or in 
      combination with standard brush cytology (BC) in patients who received 
      trimodality sampling for biliary strictures. METHODS: This single-center 
      retrospective cohort study included patients with biliary strictures undergoing 
      ERCP with trimodality sampling between September 2014 and April 2019. Performance 
      characteristics for each diagnostic test alone and in combination were 
      calculated. RESULTS: Two hundred four patients underwent trimodality biliary 
      sampling, including 104 (51.0%) with malignancy. The diagnostic sensitivity for 
      malignancy with BC (17.3%) significantly improved with dual modality (BC+FISH, 
      58.7%; BC+TPB, 40.4%) or trimodality sampling (68.3%; P < .001 for all 
      comparisons). Trimodality sampling improved diagnostic sensitivity for malignancy 
      compared with BC+FISH (P = .002) and BC+TPB (P < .001). There was no 
      statistically significant difference in the sensitivity of trimodality sampling 
      in detecting cholangiocarcinoma (79.7%) compared with pancreatic cancer (62.5%; 
      P = .1). Among 57 patients with primary sclerosing cholangitis (PSC), the 
      sensitivity of detecting biliary malignancy (n = 20) was 20% for BC and 
      significantly improved with the addition of FISH (80%; P < .001) but not with TPB 
      (35.0%; P = .25). Trimodality sampling did not further improve diagnostic 
      sensitivity (85%) over BC+FISH (80%) for malignancy in the setting of PSC (P = 
      1). CONCLUSIONS: Trimodality sampling improves the diagnostic sensitivity for the 
      detection of malignant biliary strictures with no significant difference in 
      sensitivity for cholangiocarcinoma compared with pancreatic cancer. However, in 
      patients with PSC, trimodality sampling was not superior to BC+FISH.
CI  - Copyright (c) 2022 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Baroud, Serge
AU  - Baroud S
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Sahakian, Alexander J
AU  - Sahakian AJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Sawas, Tarek
AU  - Sawas T
AD  - Division of Digestive and Liver Diseases, University of Texas Southwestern, 
      Dallas, Texas, USA.
FAU - Storm, Andrew C
AU  - Storm AC
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Martin, John A
AU  - Martin JA
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Abu Dayyeh, Barham K
AU  - Abu Dayyeh BK
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Topazian, Mark D
AU  - Topazian MD
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Levy, Michael J
AU  - Levy MJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Roberts, Lewis R
AU  - Roberts LR
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Gores, Gregory J
AU  - Gores GJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Petersen, Bret T
AU  - Petersen BT
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Chandrasekhara, Vinay
AU  - Chandrasekhara V
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20211203
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
CIN - Gastrointest Endosc. 2022 May;95(5):893-895. PMID: 35282880
CIN - Gastrointest Endosc. 2022 Jun;95(6):1284-1285. PMID: 35589212
MH  - *Bile Duct Neoplasms/complications/diagnosis/pathology
MH  - Bile Ducts, Intrahepatic/pathology
MH  - *Cholangiocarcinoma/complications/diagnosis/pathology
MH  - Cholangiopancreatography, Endoscopic Retrograde
MH  - *Cholangitis, Sclerosing/complications/diagnosis/pathology
MH  - *Cholestasis/pathology
MH  - Constriction, Pathologic/diagnosis/etiology/pathology
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - *Pancreatic Neoplasms/complications/diagnosis
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
EDAT- 2021/12/07 06:00
MHDA- 2022/04/26 06:00
CRDT- 2021/12/06 20:11
PHST- 2021/08/06 00:00 [received]
PHST- 2021/11/12 00:00 [accepted]
PHST- 2021/12/07 06:00 [pubmed]
PHST- 2022/04/26 06:00 [medline]
PHST- 2021/12/06 20:11 [entrez]
AID - S0016-5107(21)01848-4 [pii]
AID - 10.1016/j.gie.2021.11.029 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2022 May;95(5):884-892. doi: 10.1016/j.gie.2021.11.029. Epub 
      2021 Dec 3.