Utility of pancreatic duct brushing for diagnosis of pancreatic carcinoma

Abstract

Although further studies with a large number of patients are needed, our results suggest that with recent improvements of the brushing technique, pancreatic duct brushing is a useful and safe method for the differential diagnosis of malignancy from benign diseases of the pancreas.

A case of pancreatic carcinoma with suspected autoimmune pancreatitis

“…In the case presented, we obtained a number of imaging tests and biopsy and brush cytology from the areas of stenosis of the pancreaticobiliary duct, and we were able to confirm the diagnosis of adenocarcinoma in a patient with several features of AIP. Endoscopic-ultraonography-guided fineneedle aspiration biopsy (EUS-FNAB) is an another option having superior sensitivity for carcinoma (82% [18] to 93% [19]) than the ERCP approach (47% [19] to 76% [20]). Although the sampling size is limited and sometimes not large enough to make a diagnosis, the typical histology of AIP is sometimes obtained by EUS-FNA [21].…”

Routine brush cytology and fluorescence in situ hybridization for assessment of pancreatobiliary strictures

“…The sensitivity of pancreatic and bile duct brushings ranges from 47% to 80% and 18% to 80%, respectively. [1][2][3][4][5][6][7][8][9] Several trials have been undertaken to improve sensitivity of pancreatobiliary brush cytology by combining routine cytology with molecular markers, for example, detection of K-ras mutation, p53 mutation, or telomerase activity. However, those studies did not clearly confirm their diagnostic utility.…”

“…The diagnostic value of cross-sectional imaging studies may be limited in case of malignant strictures because of the possible longitudinal growth of tumor along the duct wall. [1][2][3][4][5][6][7][8][9] Serologic tumor markers such as CA 19-9 have low sensitivity in detection of early cancer, and their serum levels can be elevated in patients with benign conditions like bacterial cholangitis or chronic pancreatitis. 10 …”

Endoscopic Management of Pancreatic Cancer: From Diagnosis to Palliative Therapy

“…(Chen 2007;Yamaguchi et al, 2005) Brush cytology of pancreatic duct strictures or elevated intraductal lesions during ERCP has a sensitivity and specificity to detect malignancy of 48-76% and 100%, respectively, and accuracy of 70-76.4%. (Telford & Carr-Locke, 2002;Chen 2007;Ferrari et al, 1994;Vandervoort et al, 1999;Uchida et al, 2007) Accuracy may be influenced by location of sampling within the pancreas, technical errors and interpretation of the sample. (Chen 2007) Strictures located at the head and body of the pancreas usually yield high rates of positive cytology.…”