Digestive Diseases and Sciences (2018) 63:549–550 https://doi.org/10.1007/s10620-017-4865-7 EDITORIAL Cytologic Diagnosis of Biliary Strictures: FISH or Cut the Sensitivity Rate? 1 2 Douglas G. Adler · Benjamin Witt Published online: 12 January 2018 © Springer Science+Business Media, LLC, part of Springer Nature 2018 The definitive diagnosis of a malignant biliary stricture with the nuclear DNA of individual cells in a cytologic remains difficult, even if cancer is strongly suspected. sample obtained from brushings of a biliary stricture. The Whereas some subsets of patients are relatively easy to diag- most commonly clinically used FISH-based test adopts the nose (i.e., those with pancreatic masses causing extrahepatic UroVysion™ test, originally developed for detecting urothe- biliary obstruction), many patients can defy even the most lial carcinoma in voided urine specimens, to biliary brush- exhaustive diagnostic efforts. Specifically, cholangiocarci - ings. The FISH probes detect polysomy of chromosomes noma arising in patients with and without primary scleros- 3, 7, and 17 and may also include detection of deletion of ing cholangitis (PSC) can be extremely difficult to diagnose, chromosome locus 9p21, genetic abnormalities typical of since these lesions are often hypocellular due to fibrosis and many types of epithelial cancers, including those affecting an underlying desmoplastic reaction. These tumor features the
Digestive Diseases and Sciences – Springer Journals
Published: Jan 12, 2018
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