Roongruedee Chaiteerakij1, Emily G Barr Fritcher2, Phonthep Angsuwatcharakon3, Wiriyaporn Ridtitid3, Supakarn Chaithongrat3, Apinya Leerapun4, Todd H Baron5, Benjamin R Kipp2, Michael R Henry2, Kevin C Halling2, Rungsun Rerknimitr3, Lewis R Roberts6. 1. Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, and Mayo Clinic Cancer Center, Rochester, Minnesota, USA; Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. 2. Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, and Mayo Clinic Cancer Center, Rochester, Minnesota, USA. 3. Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. 4. Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. 5. Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, and Mayo Clinic Cancer Center, Rochester, Minnesota, USA; Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA. 6. Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, and Mayo Clinic Cancer Center, Rochester, Minnesota, USA.
Abstract
BACKGROUND AND AIMS: Fluorescence in situ hybridization (FISH) has improved the diagnostic performance of cytology for the evaluation of malignant biliary strictures in the United States and Europe. The utility of FISH for the diagnosis of biliary strictures in Asia is currently unknown. We aimed to compare the sensitivity of FISH and conventional cytology for the diagnosis of malignant biliary strictures in Thai patients. METHODS: A prospective study was performed at 2 university hospitals between 2010 and 2013. Patients being evaluated for malignant-appearing biliary strictures were included (N = 99). Bile duct brushings were collected and assessed by cytology and FISH. Sensitivities with 95% confidence intervals of cytology and FISH were the main outcome measures. RESULTS: The overall sensitivities of cytology and FISH were 38% and 55%, respectively (P = .001). For those with a diagnosis of cancer based on clinical evidence without biopsy confirmation (n = 44), the sensitivities of cytology and FISH were 43% and 57%, respectively (P = .06). For the 49 patients for whom a cancer diagnosis was confirmed by pathology, FISH had a significantly higher sensitivity than cytology, with a sensitivity of 53% versus 33%, respectively (P = .008). CONCLUSIONS: FISH improves the diagnostic performance of cytology and can be used as a complementary tool to bile duct brushing and biopsy for the evaluation of malignancy in biliary strictures in Asian populations.
BACKGROUND AND AIMS: Fluorescence in situ hybridization (FISH) has improved the diagnostic performance of cytology for the evaluation of malignant biliary strictures in the United States and Europe. The utility of FISH for the diagnosis of biliary strictures in Asia is currently unknown. We aimed to compare the sensitivity of FISH and conventional cytology for the diagnosis of malignant biliary strictures in Thai patients. METHODS: A prospective study was performed at 2 university hospitals between 2010 and 2013. Patients being evaluated for malignant-appearing biliary strictures were included (N = 99). Bile duct brushings were collected and assessed by cytology and FISH. Sensitivities with 95% confidence intervals of cytology and FISH were the main outcome measures. RESULTS: The overall sensitivities of cytology and FISH were 38% and 55%, respectively (P = .001). For those with a diagnosis of cancer based on clinical evidence without biopsy confirmation (n = 44), the sensitivities of cytology and FISH were 43% and 57%, respectively (P = .06). For the 49 patients for whom a cancer diagnosis was confirmed by pathology, FISH had a significantly higher sensitivity than cytology, with a sensitivity of 53% versus 33%, respectively (P = .008). CONCLUSIONS: FISH improves the diagnostic performance of cytology and can be used as a complementary tool to bile duct brushing and biopsy for the evaluation of malignancy in biliary strictures in Asian populations.
Authors: Christian Brooks; Valerie Gausman; Chanthel Kokoy-Mondragon; Khushboo Munot; Sunil P Amin; Amit Desai; Claudine Kipp; John Poneros; Amrita Sethi; Frank G Gress; Michel Kahaleh; Vundavalli V Murty; Reem Sharaiha; Tamas A Gonda Journal: Dig Dis Sci Date: 2018-01-20 Impact factor: 3.199
Authors: Vladimir M Kushnir; Daniel K Mullady; Koushik Das; Gabriel Lang; Thomas G Hollander; Faris M Murad; Sara A Jackson; Nicole A Toney; Sydney D Finkelstein; Steven A Edmundowicz Journal: J Clin Gastroenterol Date: 2019-10 Impact factor: 3.062