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News

Advanced cytologic techniques detect pancreatobiliary cancer

Fluorescence and digital image analysis increase the sensitivity for the diagnosis of malignant pancreatobiliary strictures, reports October's Gastroenterology.

News image

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Digital image analysis and fluorescence in situ hybridization have recently been developed to help identify malignant pancreatobiliary strictures.

Dr Laura Moreno Luna and colleagues from Minnesota evaluated these 2 advanced cytologic techniques for detecting aneuploidy.

The researchers assessed the clinical utility of cytology, digital image analysis, and fluorescence in situ hybridization for the identifying malignant pancreatobiliary strictures.

The research team conducted brush cytologic specimens from 233 consecutive patients.

Fluorescence in situ hybridization had a sensitivity between 35% and 60%
Gastroenterology

The patients underwent endoscopic retrograde cholangiopancreatography for pancreatobiliary strictures.

The research team stratified 33 strictures as proximal, and 114 as distal based on whether they occurred above or below the cystic duct, respectively.

The researchers analyzed 86 strictures in patients with primary sclerosing cholangitis separately.

The research team found that the performances of the tests were similar despite the stratification.

Conventional cytology has a low sensitivity, between 4% and 20%, but had 100% specificity.

Because of the high specificity for cytology, the team assessed the performance of the other tests when conventional cytology was negative.

In this clinical context, the team found that fluorescence in situ hybridization had a sensitivity between 35% and 60%.

The team observed that fluorescence had this sensitivity when assessing for chromosomal gains while preserving the specificity of cytology.

The sensitivity and specificity of digital image analysis was intermediate as compared with routine cytology and fluorescence in situ hybridization.

However, the team noted that the specificity of digital image analysis was additive to fluorescence in situ hybridization values.

It demonstrated only trisomy of chromosome 7 or chromosome 3.

Dr Luna's team concludes, “Fluorescence in situ hybridization and digital image analysis increase the sensitivity for the diagnosis of malignant pancreatobiliary tract strictures over that obtained by conventional cytology.”

“It also maintains an acceptable specificity.”

Gastroenterol 2006: 131(4): 1064-72
18 October 2006

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