2011
DOI: 10.1309/ajcpdulioeotuz5h
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Identification of Malignant Cytologic Criteria in Pancreatobiliary Brushings With Corresponding Positive Fluorescence In Situ Hybridization Results

Abstract: Cytologic evaluation of pancreatobiliary brushings is specific but poorly sensitive for malignancy. Detection of polysomic cells by fluorescence in situ hybridization (FISH) is significantly more sensitive than routine cytology with similar specificity. The purpose of this study was to identify cytologic criteria most associated with malignancy in specimens unaffected by sample failure. Endoscopic brushings were split equally for routine cytologic and FISH analyses per clinical practice. We retrospectively eva… Show more

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Cited by 47 publications
(70 citation statements)
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“…These differences may be related to case selection bias. Similarly, Barr Fritcher et al 26 found that the ratio of PDAC to cholangiocarcinoma was reversed, with 60.7% bile duct carcinomas and 35.7% PDACs, which may be population or case selection related. The cohort of Barr Fritcher and colleagues 26 included 1 primary gallbladder carcinoma and 1 ampullary adenocarcinoma among positive cases.…”
Section: Discussionmentioning
confidence: 94%
“…These differences may be related to case selection bias. Similarly, Barr Fritcher et al 26 found that the ratio of PDAC to cholangiocarcinoma was reversed, with 60.7% bile duct carcinomas and 35.7% PDACs, which may be population or case selection related. The cohort of Barr Fritcher and colleagues 26 included 1 primary gallbladder carcinoma and 1 ampullary adenocarcinoma among positive cases.…”
Section: Discussionmentioning
confidence: 94%
“…Molecular techniques have been successfully applied to improve sensitivity for the detection of cancer with detection of mutations serving as an efficacious ancillary tool to complement microscopic evaluation [15,16,17,18]. In particular, fluorescent in situ hybridization (FISH) has attracted significant interest as it can confer an additive benefit of 10–25% increased sensitivity for the detection of bile duct cancer [16,17,18,19].…”
Section: Discussionmentioning
confidence: 99%
“…In particular, fluorescent in situ hybridization (FISH) has attracted significant interest as it can confer an additive benefit of 10–25% increased sensitivity for the detection of bile duct cancer [16,17,18,19]. FISH is usually performed on bile duct brushing cytology slides using a small panel of marker probes optimized for the detection of urinary bladder cancer [16,17,18,19]. The technique is robust, though in clinical practice it shares the same limitation of low cellularity and sampling variation that hinders cytology evaluation.…”
Section: Discussionmentioning
confidence: 99%
“…The benefit of having cytotechnologists evaluate these specimens is that there is a strong correlation between the morphological features of the 4′,2-diamidino-2-phenylindole (DAPI)-stained nuclei and an abnormal FISH signal pattern. More specifically, cells with abnormal FISH signal patterns often have mottled chromatin staining patterns with large, irregularly shaped nuclei, very similar to the nuclear architecture observed in Pap-stained urothelial carcinoma cells [14,15]. As a result, cytotechnologists are able to use a scanning technique similar to that utilized by conventional cytology to recognize cells that are more likely to be abnormal by FISH, and ignore entities that may mimic abnormalities such as apoptotic or overlapping cells.…”
Section: The Role Of the Mayo Clinic Cytotechnologistmentioning
confidence: 99%