Fluorescence in situ hybridization for diagnosis of cholangiocarcinoma in primary sclerosing cholangitis: a systematic review and meta-analysis

Navaneethan, Udayakumar; Njei, Basile; Venkatesh, Preethi G.K.; Vargo, John J.; Parsi, Mansour A.

doi:10.1016/j.gie.2013.11.001

Cited by 125 publications

(88 citation statements)

References 25 publications

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“…However, the sensitivity of brush cytology for CCA is limited [23] . Including FISH can augment the positive predictive value of brush cytology [24] . Recently, endoscopic ultrasound-guided fine needle aspiration showed improved sensitivity for malignant biliary strictures and should be considered whenever brush results are inconclusive in patients with a suspicion of CCA [25,26] .…”

Section: Differential Diagnosismentioning

confidence: 99%

Diagnosis, Differential Diagnosis, and Epidemiology of Primary Sclerosing Cholangitis

Ponsioen¹

2015

Dig Dis

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According to recent guidelines, primary sclerosing cholangitis (PSC) is diagnosed when a patient has a cholestatic liver enzyme profile, characteristic bile duct changes on imaging, and when secondary causes of sclerosing cholangitis are excluded. In patients with a clinical suspicion but normal cholangiography, a liver biopsy is indicated to establish a diagnosis of small duct PSC. Several other disease entities such as IgG4-associated cholangitis (IAC), cholangiocarcinoma (CCA), and secondary causes of sclerosing cholangitis such as choledocholithiasis, AIDS-cholangiopathy, ischemia, surgical bile duct trauma, or mast cell cholangiopathy can mimic PSC. IAC can be differentiated from PSC by applying the HISORt criteria including the serum IgG4 level. In cases where serum IgG4 is less than 2 × ULN, the ratio of IgG4/IgG1 >0.24 is indicative for IAC. Choledocholithiasis with recurrent cholangitis as a cause of sclerosing cholangitis can pose a conundrum, since PSC itself is associated with an increased prevalence of gallstones. The epidemiology of PSC worldwide has been poorly described. Incidence and prevalence rates vary from 0-1.3 and 0-16.2 per 100,000 inhabitants respectively. However, these figures are not based on population-based cohorts. A recent large population-based cohort from the Netherlands reported an incidence of 0.5 and a prevalence of 6/100,000. Approximately 10% fulfil the criteria for small duct PSC. At diagnosis of PSC, concurrent inflammatory bowel disease (IBD), primarily ulcerative colitis or Crohn's colitis is present in 50%, but increasing to 80%, 10 years or more after diagnosis. Conversely, 3% of IBD patients will develop PSC. PSC predisposes to malignancy. The estimated cumulative risk of developing CCA after 30 years is 20%. For colorectal carcinoma in PSC/colitis patients, the estimated cumulative risk at 30 years is 13%.

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Section: Differential Diagnosismentioning

confidence: 99%

Diagnosis, Differential Diagnosis, and Epidemiology of Primary Sclerosing Cholangitis

Ponsioen¹

2015

Dig Dis

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“…Multiple reports show that in up to 60% of patients with negative standard cytology, UroVysion ™ FISH can confirm the diagnosis of CCA 80–83 . In a meta-analysis of patients with PSC, FISH polysomy showed 51% sensitivity and 93% specificity 84 . Due to the influence of pre-test probability on biomarker performance, it is important not to use FISH in settings where the suspicion of cancer is very low, such as in patients with biliary stone disease.…”

Section: Cholangiocarcinomamentioning

confidence: 99%

Screening for Hepatocellular Carcinoma and Cholangiocarcinoma: Can Biomarkers Replace Imaging?

Lozada

Chaiteerakij

Roberts

2015

Curr Hepatology Rep

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“…87 The recent meta-analysis in 828 patients with PSC yielded pooled sensitivity of 68% and specificity of 70% for CC detection. 88 To increase the sensitivity even further, the first study of tri-modal approach was recently published. Sixtyone patients who underwent brush cytology alone were compared with 50 patients who were managed with brushings, biopsy, and FISH.…”

Section: Fishmentioning

confidence: 99%

Comprehensive management of cholangiocarcinoma: Part I. Diagnosis

Papafragkakis

Lee

2017

Int J Gastrointest Interv

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A B S T R A C TCholangiocarcinoma is the second most common primary hepatic malignancy and its incidence is increasing worldwide. Classification and staging of intrahepatic, perihilar, and distal cholangiocarcinomas provide useful prognostic information and further guide in their management. Establishing diagnosis is frequently challenging and may require a multi-modality approach that includes advanced radiological imaging studies and procedures for tissue acquisition; the endoscopic procedures that have been utilized in the management of cholangiocarcinoma comprise endoscopic retrograde cholangiopancreatography with brushing and biopsy, endoscopic ultrasound-guided fine needle aspiration, cholangioscopy with targeted biopsy, and intraductal confocal endomicroscopy. In this review, we will examine the strengths and limitations of each diagnostic tool and assess the serum and bile tumor markers.

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Fluorescence in situ hybridization for diagnosis of cholangiocarcinoma in primary sclerosing cholangitis: a systematic review and meta-analysis

Cited by 125 publications

References 25 publications

Diagnosis, Differential Diagnosis, and Epidemiology of Primary Sclerosing Cholangitis

Diagnosis, Differential Diagnosis, and Epidemiology of Primary Sclerosing Cholangitis

Screening for Hepatocellular Carcinoma and Cholangiocarcinoma: Can Biomarkers Replace Imaging?

Comprehensive management of cholangiocarcinoma: Part I. Diagnosis

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