Molecular diagnostic testing as an adjunct to morphologic evaluation of pancreatic ductal system brushings: potential augmentation for diagnostic sensitivity.

摘要: Malignancies arising from the pancreatic and biliary ductal systems present gastroenterologist pathologist with diagnostic challenges. Tumors of and/or system may as either duct strictures or mass lesions. When lesions without associated demonstrable masses, brushing cytology represent only reasonable technique aside open biopsy. Diagnostic sensitivities for have ranged 18 to 90%. Positive diagnoses malignancy are great clinical value but a negative result is relatively little aid when radiographic findings suspicious malignancy. A variety techniques been used in an attempt improve sensitivity cytology. These included immunohistochemistry various molecular techniques. Using high resolution melting curve technique, we performed mutational analysis on 20 bile specimens mutations p53, K-ras, BRAF, EGFR genes. Eleven had corresponding surgical specimens, which were similarly analyzed. Our series twelve adenocarcinomas, one islet cell tumor, case dysplasia, six benign cases. K-ras found 3 out 12 malignancies. No B-raf detected single p53 mutation adenocarcinoma was specimen. dysplasia. Only 8% adenocarcinomas 33% cases mutations. Mutational did not appear cytologic detection by brushings. Diagn. Cytopathol. 2007;35:218–224. © 2007 Wiley-Liss, Inc.