Advanced cytologic approaches for the diagnosis of pancreatobiliary cancer

Purpose of Review: The review will provide information on the use of advanced cytologic techniques such as fluorescence in-situ hybridization (FISH) and digital image analysis (DIA) for the detection of pancreatobiliary malignancy. Recent Findings: FISH and DIA are techniques that can be used to assess cells for chromosomal alterations. Since tumor cells are frequently aneuploid, FISH and DIA can be used to detect malignancy. Recent studies have shown that the application of FISH and DIA to pancreatobiliary brushing specimens increases the sensitivity of detection of malignancy over conventional cytology. Summary: The diagnosis of malignancy in the pancreatobiliary tract confers a bleak prognosis due to the aggressive nature of these tumors and ineffective treatment options. Early detection of tumor is more likely to provide the patient with the option of surgical resection, which offers the best chance for cure. Current pathologic testing techniques, namely biopsy and routine cytology, are limited in their ability to detect tumor. FISH and DIA increase the sensitivity of pancreatobiliary malignancy compared to routine cytology.