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Diagnostic p53 immunostaining of endobiliary brush cytology
Author(s) -
Tascilar Metin,
Sturm Patrick D.J.,
Caspers Eric,
Smit Miriam,
Polak Mirjam M.,
Huibregtse Kees,
Noorduyn L. Arnold,
Offerhaus G. Johan A.
Publication year - 1999
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19991025)87:5<306::aid-cncr11>3.0.co;2-y
Subject(s) - medicine , immunostaining , carcinoma , bile duct carcinoma , bile duct , cytology , bile duct cancer , pathology , pancreatitis , lymph node , endoscopic retrograde cholangiopancreatography , cancer , gastroenterology , immunohistochemistry
BACKGROUND Endobiliary brush cytology is important in the distinction of malignant and benign causes of extrahepatic bile duct obstruction. The additional diagnostic value of p53 immunostaining on these cytology specimens was assessed. METHODS All patients with extrahepatic bile duct obstruction who underwent endoscopic retrograde cholangiopancreatography (ERCP) with endobiliary brush cytology and subsequent surgery at the Academic Medical Center in Amsterdam during a 3‐year period were studied. p53 Immunocytology was compared with the corresponding conventional light microscopic cytology and p53 immunostaining of the subsequent surgical specimen. RESULTS Fifty‐three patients with the following diagnoses were included: pancreatic carcinoma (23), bile duct carcinoma (15), ampullary carcinoma (5), lymph node metastases (2), carcinoma of unknown origin (4), chronic pancreatitis (3), and primary sclerosing cholangitis (1). Fifty‐one percent of the carcinomas showed positive p53 immunostaining; all four surgical specimens without carcinoma were negative. The sensitivities of conventional light microscopic cytology, p53 immunocytology, and both tests combined were 29%, 24%, and 43%, respectively. These sensitivities were higher in cases of bile duct carcinoma (46%, 40%, and 66%) compared with cases of pancreatic carcinoma (13%, 9%, and 22%). Specificities of both tests were 100%. CONCLUSIONS p53 Immunostaining on endobiliary brush cytology may be helpful in the diagnosis of malignant extrahepatic bile duct stenosis, especially in patients with bile duct carcinoma. Cancer (Cancer Cytopathol) 1999;87:306–11. © 1999 American Cancer Society.