Identification of malignant cytologic criteria in pancreatobiliary brushings with corresponding positive fluorescence in situ hybridization results

Emily G. Barr Fritcher, Jill L. Caudill, Joshua E. Blue, Kris Djuric, Lesley Feipel, Benard K. Maritim, Ameera A. Ragheb, Kevin C. Halling, Michael R. Henry, Amy C. Clayton

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

Dr Halling has a patent on and receives royalties from the sale of the FISH probe set (UroVysion, Abbott Molecular, Des Plaines, IL) mentioned in this article. Cytologic evaluation of pancreatobiliary brushings is specific but poorly sensitive for malignancy. Detection of polysomic cells by fluorescence in situ hybridization (FISH) is significantly more sensitive than routine cytology with similar specificity. The purpose of this study was to identify cytologic criteria most associated with malignancy in specimens unaffected by sample failure. Endoscopic brushings were split equally for routine cytologic and FISH analyses per clinical practice. We retrospectively evaluated 16 cytologic criteria on Papanicolaou-stained slides. We assumed that the presence of polysomic cells by FISH indicated successful tumor sampling in specimens from patients with pathologic evidence of malignancy on follow-up. We compared cytologic criteria of malignant brushings with corresponding positive FISH results (positive control, n = 39) with those without evidence of malignancy and corresponding negative FISH results (negative control, n = 30). The presence of single abnormal cells, irregular nuclear membranes, and enlarged nuclei were independent predictors of malignancy by logistic regression (P < .05).

Original languageEnglish (US)
Pages (from-to)442-449
Number of pages8
JournalAmerican journal of clinical pathology
Volume136
Issue number3
DOIs
StatePublished - Sep 1 2011

Keywords

  • Biliary cytology
  • Cholangiocarcinoma
  • Morphology
  • Pancreatic carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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    Barr Fritcher, E. G., Caudill, J. L., Blue, J. E., Djuric, K., Feipel, L., Maritim, B. K., Ragheb, A. A., Halling, K. C., Henry, M. R., & Clayton, A. C. (2011). Identification of malignant cytologic criteria in pancreatobiliary brushings with corresponding positive fluorescence in situ hybridization results. American journal of clinical pathology, 136(3), 442-449. https://doi.org/10.1309/AJCPDULIOEOTUZ5H