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Endoscopic ultrasound guided fine needle aspiration with fluorescence in situ hybridization analysis in 104 patients with pancreatic mass
Author(s) -
Ribeiro Afonso,
Peng Jinghong,
Casas Carmen,
Fan YaoShan
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12575
Subject(s) - medicine , cytology , malignancy , fluorescence in situ hybridization , polysomy , pancreatic cancer , pathology , endoscopic ultrasound , radiology , pancreatitis , cancer , fine needle aspiration , adenocarcinoma , biopsy , gastroenterology , biology , biochemistry , chromosome , gene
Background and Aim Diagnosis of pancreatic malignancy is often based on cytological specimens collected by endoscopic ultrasound guided fine needle aspiration ( EUS FNA ). Several factors can decrease sensitivity of EUS FNA for pancreatic cancer: well‐differentiated tumors, pancreatitis, blood, necrosis and slides with low cellularity. The objective of this study is to report on the use of fluorescence in situ hybridization ( FISH ) analysis combined with cytology in pancreatic masses. Methods EUS database and medical records of patients referred for EUS between J anuary 2009 through august 2013 were reviewed. Data on cytology, FISH and surgical pathology were reviewed. Surgical pathology, death or extended clinical follow‐up were used to verify correct diagnosis of malignancy. FISH performed using a four‐set DNA probe for chromosomes 3, 7, 17, and band 9p21 in patients with inconclusive immediate cytology reading. Sensitivity of cytology and FISH were compared. Results Study cohort comprised of 104 patients with FISH analysis on EUS FNA specimens of pancreatic masses (74 adenocarcinoma, 7 neuroendocrine tumor and 23 benign. Sensitivity of cytology and FISH for carcinoma was respectively: 62% and 81%. Sensitivity of FISH + cytology was 89%. The specificity of FISH and cytology was 100%. The most common abnormality on FISH was a 9p21 deletion seen in 43 patients (58%) followed by polysomy of 7 (46%). FISH detected malignancy in 23 patients with negative cytology. Conclusions In patients with inconclusive immediate cytology reading, FISH is superior to cytology and improves overall sensitivity. The 9p21 deletion is the most common abnormality seen in this cohort of patients with pancreatic cancer.