NEW YORK (Reuters Health) - Fluorescence in situ hybridization (FISH) offers advantages over routine cytology in detecting malignant bile duct strictures, researchers report in the September issue of the American Journal of Gastroenterology.
“The use of FISH allows a confident diagnosis of cancer in cells obtained from endoscopic brushings before the cells have changes that can be detected by standard microscopy,” senior investigator Dr. Lewis R. Roberts told Reuters Health. “Earlier diagnosis allows earlier and more effective treatment of the cancer.”
He added that FISH “exploits the fact that cancer cells characteristically have abnormal numbers of chromosomes; this technique measures the number of copies of a subset of chromosomes that frequently show abnormalities in cancer.”
Dr. Roberts of the Mayo Clinic College of Medicine, Rochester, Minnesota and colleagues collected bile duct brushings and aspirate specimens from 131 patients undergoing evaluation for malignant strictures.
Both specimen types were assessed by FISH and the brushing specimens were evaluated by cytology.
Overall, 66 of the patients had evidence of malignancy. Of these, 39 had cholangiocarcinoma, 19 had pancreatic carcinoma and 8 had other types of malignancy.
The sensitivity of FISH in detecting malignancy from brushings in these patients was 34%. This was significantly greater than the 15% seen with cytology (p< 0.01). The combined sensitivity of FISH for bile aspirate and brushing specimens was 35%.
“The specificity of FISH and cytology brushings were 91% and 98% (p = 0.06), respectively,” they report.
In an accompanying editorial, Drs. Erik-Jann Wamsteker and Michelle A. Anderson of the University of Michigan Health System, Ann Arbor, conclude that “although larger studies are indicated, the modality shows considerable promise for future clinical use.”
Source: Am J Gastroenterol 2004;99:1675-1681:1682-1683. [ Google search on this article ]
MeSH Headings:Bile Duct Diseases: Bile Duct Neoplasms: Biliary Tract Neoplasms: Cytological Techniques: Digestive System Neoplasms: Environment and Public Health: Epidemiologic Methods: Genetic Techniques: Health: Health Occupations: Health Services Administration: Mathematics: Medicine: Investigative Techniques: Neoplasms: Neoplasms by Site: Physical Sciences: Population Characteristics: Preventive Medicine: Public Health: Quality of Health Care: Sensitivity and Specificity: Specialties, Medical: Statistics: Technology: Technology, Industry, and Agriculture: Technology, Medical: Epidemiologic Research Design: Allied Health Occupations: In Situ Hybridization: In Situ Hybridization, Fluorescence: Health Care Quality, Access, and Evaluation: Health Care Evaluation Mechanisms: Cytogenetic Analysis: Analytical, Diagnostic and Therapeutic Techniques and Equipment: Biological Sciences: Diseases: Health Care: Physical Sciences: Technology, Food and BeveragesCopyright © 2002 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
