The value of DNA image cytometry combined with brush routine cytology in diagnosing indeterminate biliary strictures: A large sample size retrospective study

Xia Yang, Liqi Sun, Jiefang Guo, Li Gao, Chengyong Qin, Zhendong Jin
Journal of Gastroenterology and Hepatology 2019 April 8

BACKGROUND AND OBJECTIVE: Brush cytology is widely applied to diagnosis indeterminate biliary stricture but suffer from low sensitivity. Changes in DNA content is a character of malignant cell and can be detected by DNA image cytometry (DNA-ICM). The study aimed to estimate the value of routine cytology (RC), DNA-ICM, and their combination in diagnosing indeterminate biliary strictures.

METHODS: A total of 362 patients who underwent both RC and DNA-ICM tests were analysis. Their results were retrospectively applied to final diagnoses. Diagnostic value were compared among RC,DNA-ICM and their combination based on location of strictures.

RESULT: The DNA-ICM and combination of 2 methods had higher diagnostic accuracy than RC in all strictures(63.3% vs 42.3%,P<0.001,64.36% vs42.3%,P<0.001) and in distal strictures(65.36% vs 42.81%,P<0.001,66.01%vs42.81%,P<0.001). But in proximal strictures, DNA-ICM showed no superior(51.8% vs42.81%,P=0.184). Combination of 2 methods was not fully significant superior to RC in proximal strictures(55.36%vs 39.29%,P=0.089). After classification of 'suspicious for malignancy' as positive for malignancy, the diagnostic accuracy of DNA-ICM was still higher than that of RC in all strictures(63.3% vs 51.9%,P=0.002) and in distal strictures(65.36% vs 52.29%,P=0.001). Combination of 2 methods was no superior to DNA-ICM alone (64.36%vs63.3%,P=0.757). The utilize of DNA-ICM was more accuracy in distal strictures than in proximal strictures(65.36% vs 51.8%,P=0.017).

CONCLUSION: DNA-ICM is an objective and effective addition tool with RC, especially in distal strictures. The combination of DNA-ICM and RC showed no superior to DNA-ICM alone but could improve diagnostic accuracy to RC in proximal strictures though not fully significant.


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"