细胞学检查无法明确的原发性硬化性胆管炎

Primarysclerosingcholangitiswithequivocalcytology:FluorescenceinsituhybridizationandserumCA19-9predictriskofmalignancy.

细胞学检查无法明确的原发性硬化性胆管炎：荧光原位杂交和血清CA19-9可预测癌变风险

BarrFritcherEG,VossJS,JenkinsSM,LingineniRK,ClaytonAC,RobertsLR,HallingKC,TalwalkarJA,GoresGJ,KippBR

CancerCytopathology；Volume,Issue12()

Abstract

Patientsdiagnosedwithprimarysclerosingcholangitis(PSC)anddominantstricturesoftenundergoendoscopicretrogradecholangiopancreatographywithbrushcytologytoexcludeorconfirmthedevelopmentofmalignancy.Equivocal(atypicalorsuspicious)routinecytologicresultsmayconfoundpatientmanagementdecisions,especiallyintheabsenceofamassonimaging.TheobjectiveofthecurrentstudywastoidentifyindependentpredictorsofmalignancyinpatientswithPSCwithanequivocalcytologydiagnosis.

PatientswithPSCunderwentbrushcytologyforroutinecytologyandfluorescenceinsituhybridization(FISH)duringendoscopyasperstandardcare.FISHslideswereclassifiedaspolysomyifatleast5cellsdisplayedagainof≥?2probes.Aretrospectivesearchidentifiedpatientswithoutamasslesionnotedoninitialimagingstudies,anequivocalroutinecytology,and≥?2yearsoffollow-up.

Ofpatients,30(29%)withanequivocalcytologyresultdevelopedcancerwithin2years.Serumcarbohydrateantigen19-9(CA19-9)levels≥?U/mL(hazardratio[HR]3.19;P?=?.)andpolysomy(HR8.70;P??.)wereeachfoundtobepredictiveofcancer.Of10patientswhohadelevatedCA19-9levelsandpolysomy,allwentontodevelopcancer(9within2years).Althoughonly10patientswereincludedinthissubset,the







































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