Primary Sclerosing Cholangitis Patients With Serial Polysomy Fluorescence In Situ Hybridization Results Are at Increased Risk of Cholangiocarcinoma

被引:74
|
作者
Fritcher, Emily G. Barr [2 ,3 ]
Kipp, Benjamin R. [2 ,3 ]
Voss, Jesse S. [2 ,3 ]
Clayton, Amy C. [2 ,3 ]
Lindor, Keith D. [1 ]
Halling, Kevin C. [2 ,3 ]
Gores, Gregory J. [1 ]
机构
[1] Mayo Clin & Mayo Fdn, Mayo Clin Coll Med, Div Gastroenterol & Hepatol, Rochester, MN 55905 USA
[2] Mayo Clin & Mayo Fdn, Mayo Clin Coll Med, Dept Lab Med, Rochester, MN 55905 USA
[3] Mayo Clin & Mayo Fdn, Mayo Clin Coll Med, Dept Pathol, Rochester, MN 55905 USA
来源
AMERICAN JOURNAL OF GASTROENTEROLOGY | 2011年 / 106卷 / 11期
关键词
BILE-DUCT STRICTURES; PANCREATICOBILIARY STRICTURES; HILAR CHOLANGIOCARCINOMA; BILIARY DYSPLASIA; ROUTINE CYTOLOGY; TRANSPLANTATION; TRACT;
D O I
10.1038/ajg.2011.272
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
OBJECTIVES: A polysomy fluorescence in situ hybridization (FISH) result in a pancreatobiliary brushing from a patient with primary sclerosing cholangitis (PSC) is very worrisome for carcinoma. However, treatment is not recommended unless verified by corroborative evidence of malignancy because of less than perfect test specificity in this population. The aim of this study was to evaluate the clinical outcome of PSC patients with serial polysomy FISH results. METHODS: Patients with PSC underwent endoscopic retrograde cholangiopancreatography with brushings when clinically indicated per standard practice. Brushings were evaluated by routine cytology and FISH. Retrospective review identified patients with a polysomy FISH result without definitive imaging or pathological evidence of malignancy at the time of the first polysomy, who underwent follow-up examinations including subsequent FISH testing (n = 30). Patient records were reviewed to determine clinical outcome. RESULTS: In all, 9 of 13 patients (69%) with a subsequent polysomy result (i.e., serial polysomy) were diagnosed with cholangiocarcinoma (CCA) compared with 3 of 17 patients (18%) with subsequent non-polysomy results (P = 0.008). There was a significant difference in time to a diagnosis of CCA between PSC patients with serial polysomy compared with those with subsequent non-polysomy (P = 0.01). In four patients with serial polysomy results, imaging/pathological evidence of CCA was not found until 1-2.7 years after the initial polysomy FISH result. CONCLUSIONS: FISH may detect polysomic cells in pancreatobiliary brushings before other pathological or imaging techniques identify CCA. Patients with serial polysomy FISH results are at higher risk for having CCA than those with subsequent non-polysomy FISH results.
引用
收藏
页码:2023 / 2028
页数:6
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