Diagnostic power of DNA methylation markers suggestive of cholangiocarcinoma in ERCP-based brush cytology

被引：8

作者：

Prachayakul, Varayu ^{[1
]}

Rugivarodom, Manus ^{[1
]}

Nopjaroonsri, Papatsakorn ^{[1
]}

Cheirsilpa, Kunsuda ^{[1
]}

Kamolhan, Thanpawee ^{[3
]}

Boonyaarunnate, Thiraphon ^{[4
]}

Thuwajit, Chanitra ^{[3
]}

Thuwajit, Peti ^{[3
]}

Chang, Arunchai ^{[2
]}

机构：

[1] Mahidol Univ, Dept Med, Siriraj GI Endoscopy Ctr, Div Gastroenterol,Fac Med,Siriraj Hosp, Bangkok, Thailand

[2] Hat Yai Hosp, Dept Internal Med, Div Gastroenterol, Songkhla, Thailand

[3] Mahidol Univ, Dept Immunol, Fac Med, Siriraj Hosp, 11th Floor Adulyadejvikrom Bldg, Bangkok 10700, Thailand

[4] Mahidol Univ, Dept Pathol, Fac Med, Siriraj Hosp, Bangkok, Thailand

来源：

GASTROINTESTINAL ENDOSCOPY | 2022年 / 95卷 / 01期

关键词：

IN-SITU HYBRIDIZATION; PRIMARY SCLEROSING CHOLANGITIS; BILIARY STRICTURES; SENSITIVITY; PROFILES; BIOPSIES;

D O I：

10.1016/j.gie.2021.07.005

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and Aims: Accurate differentiation between cholangiocarcinoma (CCA) and benign biliary stricture is of paramount importance. Biliary brush cytology is a simple and safe diagnostic approach that provides relatively high specificity; however, sensitivity is limited. Previous reports indicated the aberrations of DNA methylation in CCA. This study aimed to investigate the diagnostic performance of the methylation index (MI) of HOXA1 and NEUROG1 gene promoters in CCA. Methods: Patients with biliary stricture who underwent ERCP with brush cytology in Siriraj Hospital from September 2016 to December 2019 were prospectively enrolled. The MI of HOXA1 (MI_H) and MI of NEUROG1 (MI_N) were determined by quantitative methylation-specific polymerase chain reaction. The diagnostic power for CCA was tested for MI from both genes and serum carbohydrate antigen 19-9 (CA19-9). Results: Sixty-seven patients were included in the study; 41 patients had a final diagnosis of CCA, and 26 patients were determined to have a benign biliary stricture. The results showed that both MI_H and MI_N had higher sensitivity and accuracy (95.1% and 82.3% and 90.2% and 89.5%, respectively) than brush cytology (61.5% and 78.1%) and CA19-9 (69.4% and 77.8%). The combination of brush cytology, both methylation markers, and CA19-9 increased the sensitivity and accuracy to 97.4% and 91.0%. Methylation markers were positive in 5 of 6 patients with confirmed CCA whose cytology and CA19-9 were negative. Conclusions: DNA methylation increased the sensitivity for the diagnosis of CCA; therefore, the use of DNA methylation is promising for diagnosis of CCA in patients with biliary strictures. A future validation study is warranted to assess its role in clinical practice.

引用

页码：123 / +

页数：9