Immunocytochemistry for Claudin‐18 and Maspin in biliary brushing cytology increases the accuracy of diagnosing pancreatobiliary malignancies

Tokumitsu, Takako; Sato, Yuichiro; Yamashita, Atushi; Moriguchi-Goto, Sayaka; Kondo, Ken; Nanashima, Atsushi; Asada, Yujiro

doi:10.1111/cyt.12368

Cited by 17 publications

(12 citation statements)

References 28 publications

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“…Immunocytochemical studies using Mapsin and Claudin-18 are also reported to be helpful in improving the sensitivity of bile duct brushings. 19 Measurement of DNA methylation status of HOXA1 and NEUROG1 genes in left over brushed biliary cells is reported to increase sensitivity of biliary brush material. 20 Along with technical improvements in navigation of the bile ducts, we can expect a continuing evolution of sample types and tests aimed at improving the diagnostic performance of specimens from the biliary tree.…”

Section: Discussionmentioning

confidence: 99%

Effect of single operator cholangioscopy on accuracy of bile duct cytology

Aly

Mostofizadeh

Jawaid

et al. 2020

Diagnostic Cytopathology

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Introduction: This is the first study to evaluate the accuracy of bile duct brushings since the introduction of single operator cholangioscopy SpyGlass DS system in 2015. The primary aim of our study was to compare the accuracy of cytology brushings against biopsies obtained at endoscopic retrograde cholangiopancreatography (ERCP) and cholangioscopy. Method: A retrospective search for bile duct brushing specimens was performed and the charts reviewed. The gold standard for definitive diagnosis of malignancy was surgical tissue or compelling clinical evidence of malignancy. Definite negative diagnosis relied on lack of clinical/imaging features of malignancy on follow-up. Results: There was no significant difference in diagnostic accuracy of cytology specimens obtained at different procedures. Overall sensitivity for all methods was 59%, specificity 90% and accuracy of 82%. Notably, all four false-positive cases except for one were from patients with primary sclerosing cholangitis or primary biliary sclerosis. There was no significant difference in sensitivity or specificity between biopsies procured by the two methods. The combined biopsy sensitivity for all modalities was 44% with a specificity of 100%. There was 70% concordance between cytology and biopsy cases. The overall specificity and sensitivity of the combined cytology and biopsy result was 85% and 65.3%, respectively. Ranking of factors that predict clinical diagnosis shows cytology results to surpass other parameters including pancreatic mass, age and stenosis length. Similarly, the presence of two cell populations and three-dimensional clusters was not nearly as predictive of malignancy as single malignant cells. Conclusion: Biliary brush cytology specimens performed better than biopsies irrespective of whether they are procured during ERCP or cholangioscopy. The combination of cytology and biopsy had the best accuracy than either one alone.

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Section: Discussionmentioning

confidence: 99%

Effect of single operator cholangioscopy on accuracy of bile duct cytology

Aly

Mostofizadeh

Jawaid

et al. 2020

Diagnostic Cytopathology

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“…First, the authors eliminated all cases that had scant cellularity. Other studies have also tried to improve the accuracy of biliary cytology by improving specimen quality . It would be interesting to know what the performance of these new criteria would be on all cases, not just highly cellular ones.…”

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confidence: 99%

“…Other studies have also tried to improve the accuracy of biliary cytology by improving specimen quality. [6][7][8][9][10] It would be interesting to know what the performance of these new criteria would be on all cases, not just highly cellular ones. Second, the images that the authors illustrate are beautiful.…”

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confidence: 99%

Improving the diagnostic accuracy of biliary cytology

Renshaw

Gould

2019

Diagnostic Cytopathology

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“…Maspin.-Maspin is a tumor suppressor that is overexpressed in more than 90% of pancreatic ductal adenocarcinomas, 1 62, 16 7, 18 3,1 84 59% to 100% of gallbladder adenocarcinomas, 168,185 57% to 91% of adenocarcinomas of extrahepatic bile ducts, 186,187 and more than 70% of intrahepatic cholangiocarcinomas. 167,188 Malignant cells typically show strong and diffuse nuclear and cytoplasmic Figure 11.…”

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confidence: 99%

“…Benign pancreatic ducts are usually negative for maspin expression, but benign epithelial cells lining the gallbladder and extrahepatic bile ducts have been shown to be positive at a high frequency. 186,187,189 The staining can thus be difficult to interpret despite the observations that positive staining in benign biliary epithelial cells is usually focal/patchy and weaker in intensity in comparison with that seen in malignant cells.…”

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confidence: 99%

Practical Immunohistochemistry in Neoplastic Pathology of the Gastrointestinal Tract, Liver, Biliary Tract, and Pancreas

Wang¹,

Kim²,

Koo³

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Immunomarkers with diagnostic, therapeutic, or prognostic values have been increasingly used to maximize the benefits of clinical management of patients with neoplastic diseases of the gastrointestinal tract, liver, biliary tract, and pancreas. Objectives.— To review the characteristics of immunomarkers that are commonly used in surgical pathology practice for neoplasms of the gastrointestinal tract, liver, biliary tract, and pancreas, and to summarize the clinical usefulness of immunomarkers that have been discovered in recent years in these fields. Data Sources.— Data sources include literature review, authors' research data, and personal practice experience. Conclusions.— Immunohistochemistry is an indispensable tool for the accurate diagnosis of neoplastic diseases of the gastrointestinal tract, liver, biliary tract, and pancreas. Useful immunomarkers are available to help distinguish malignant neoplasms from benign conditions, determine organ origins, and subclassify neoplasms that are morphologically and biologically heterogeneous. Specific immunomarkers are also available to help guide patient treatment and assess disease aggressiveness, which are keys to the success of personalized medicine. Pathologists will continue to play a critical role in the discovery, validation, and application of new biomarkers, which will ultimately improve patient care.

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Immunocytochemistry for Claudin‐18 and Maspin in biliary brushing cytology increases the accuracy of diagnosing pancreatobiliary malignancies

Abstract: Immunocytochemical staining for Claudin-18 and Maspin improved the diagnostic sensitivity for pancreatobiliary adenocarcinomas.

Cited by 17 publications

References 28 publications

Effect of single operator cholangioscopy on accuracy of bile duct cytology

Effect of single operator cholangioscopy on accuracy of bile duct cytology

Improving the diagnostic accuracy of biliary cytology

Practical Immunohistochemistry in Neoplastic Pathology of the Gastrointestinal Tract, Liver, Biliary Tract, and Pancreas

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