Detecting Cholangiocarcinoma in the Setting of Primary Sclerosing Cholangitis: Is Biliary Tract Fluorescence In Situ Hybridization Helpful?

IF 1.2 4区医学 Q4 CELL BIOLOGY

Cytopathology Pub Date : 2024-10-04 DOI:10.1111/cyt.13452

Lauren J Miller, Isabella M Holmes, Heather I Chen-Yost, Brian Smola, Madelyn Lew, Judy Pang

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引用次数: 0

Abstract

Introduction/objective: Biliary brushing cytology (BB) to detect cholangiocarcinoma (CCA) is integral in the surveillance of patients with primary sclerosing cholangitis (PSC). Since reactive changes can mimic carcinoma, indeterminant results are frequent. Fluorescence in situ hybridization (FISH) using the UroVysion probe set has been advocated to enhance the detection of CCA. This study evaluates the performance of FISH for detecting CCA in patients with and without PSC.

Materials and methods: A query of our pathology database for atypical and suspicious BB with concurrent FISH results was performed from 2014 to 2021. FISH (using UroVysion probe set containing centromere enumeration probes to chromosomes 3, 7, and 17) was positive if at least 5 cells demonstrated polysomy. Electronic medical records were reviewed to identify patients with PSC and CCA. CCA was confirmed by pathology or clinical impression.

Results: Of the 65 patients (103 BB) in the PSC cohort, 59 patients (94 BB) without CCA and 6 patients (9 BB) with CCA were identified. 33 non-PSC patients (41 BB) with CCA were included for comparison. Positive FISH was highest in non-PSC patients with CCA (10/41 BB, 24%). Positive FISH was seen in both PSC with (1/9 BB, 11%) and without (2/94 BB, 2%) CCA.

Conclusions: FISH positivity was lower than expected and was positive in PSC patients without CCA. These results question the clinical utility of FISH for CCA surveillance in PSC patients.

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在原发性硬化性胆管炎的情况下检测胆管癌：胆道荧光原位杂交是否有用？

引言/目的：胆道刷状细胞学（BB）检测胆管癌（CCA）是监测原发性硬化性胆管炎（PSC）患者不可或缺的一部分。由于反应性变化可模拟癌变，因此经常出现不确定的结果。使用 UroVysion 探针组进行荧光原位杂交（FISH）可提高 CCA 的检测率。本研究评估了荧光原位杂交技术在PSC患者和非PSC患者中检测CCA的性能：从 2014 年到 2021 年，我们在病理数据库中查询了非典型和可疑 BB，并同时获得了 FISH 结果。如果至少有5个细胞显示多体，则FISH（使用UroVysion探针组，其中包含3、7和17号染色体的中心粒计数探针）结果为阳性。审查电子病历以确定 PSC 和 CCA 患者。CCA由病理或临床印象证实：在 65 名 PSC 患者（103 名 BB）中，有 59 名患者（94 名 BB）未患有 CCA，6 名患者（9 名 BB）患有 CCA。33名患有CCA的非PSC患者（41名BB）被纳入对比。在患有 CCA 的非 PSC 患者中，FISH 阳性率最高（10/41 BB，24%）。在患有（1/9 BB，11%）和未患有（2/94 BB，2%）CCA的PSC患者中，FISH均呈阳性：结论：FISH阳性率低于预期，而且在无CCA的PSC患者中也呈阳性。结论：FISH 阳性率低于预期，在无 CCA 的 PSC 患者中呈阳性。这些结果对 FISH 在 PSC 患者 CCA 监测中的临床实用性提出了质疑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cytopathology 生物-病理学

CiteScore

2.30

自引率

15.40%

发文量

107

审稿时长

6-12 weeks

期刊介绍： The aim of Cytopathology is to publish articles relating to those aspects of cytology which will increase our knowledge and understanding of the aetiology, diagnosis and management of human disease. It contains original articles and critical reviews on all aspects of clinical cytology in its broadest sense, including: gynaecological and non-gynaecological cytology; fine needle aspiration and screening strategy. Cytopathology welcomes papers and articles on: ultrastructural, histochemical and immunocytochemical studies of the cell; quantitative cytology and DNA hybridization as applied to cytological material.