Department of Pathology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, China.
Imaging department, Henan Provincial Hospital, Northwest corner of intersection of Dongting Lake Road and Huaxia Avenue in Zhengzhou Airport Economic Comprehensive Experimental Zone, Zhengzhou, 450000, Henan, China.
BMC Gastroenterol. 2020 Nov 4;20(1):367. doi: 10.1186/s12876-020-01439-0.
Using fluorescence in situ hybridisation (FISH) to detect any gain of chromosomes 3, 7, or 17 and loss of the 9p21 locus has been proven to be sensitive in the diagnosis of pancreatobiliary tumors. However, both genetic and environmental factors contribute to the pathogenesis of pancreatobiliary tumors. Therefore, it is unknown whether this method is suitable for Chinese patients with pancreatobiliary tumors. This study aims to compare the sensitivity, specificity, predictive values and accuracy of cytology, ERCP/MRCP and FISH based on Chinese patients with pancreatobiliary tumors,and to analyze differences between brushing-based and formalin-fixed paraffin-embedded (FFPE)-based FISH.
A total of 66 brush cytology specimens obtained during ERCP were detected by FISH and cytology test respectively to compare the sensitivity, specificity, predictive values and accuracy. Besides, FFPE-based FISH was performed on 46 corresponding paraffin sections of pancreatobiliary tumors obtained by surgical resection.
Our findings demonstrate that FISH greatly improves diagnostic sensitivity and negative predictive value compared to ERCP/MRCP and cytology without much reduction in specificity and positive predictive value. However, our results also indicate that FFPE-based FISH could not effectively identify the false-negative of brushing-based FISH.
We believe that FISH can effectively distinguish true positive and false positive results of cytological or radiological suspicions of malignancy. However, FFPE-based FISH still does not precisely recognize the false-negative of brushing-based FISH. Both cytology-based and PPFE-based FISH had limitation in some specimens.
荧光原位杂交（FISH）检测染色体 3、7 或 17 的任何增益以及 9p21 基因座的缺失已被证明在胰胆管肿瘤的诊断中具有较高的敏感性。然而，遗传和环境因素都促成了胰胆管肿瘤的发病机制。因此，尚不清楚这种方法是否适用于中国的胰胆管肿瘤患者。本研究旨在比较基于中国胰胆管肿瘤患者的细胞学、ERCP/MRCP 和 FISH 的敏感性、特异性、预测值和准确性，并分析基于刷检和福尔马林固定石蜡包埋（FFPE）的 FISH 之间的差异。
对 66 例 ERCP 刷检细胞学标本分别进行 FISH 和细胞学检测，比较敏感性、特异性、预测值和准确性。此外，对 46 例手术切除的胰胆管肿瘤相应石蜡切片进行 FFPE 基础 FISH。
我们的研究结果表明，与 ERCP/MRCP 和细胞学相比，FISH 大大提高了诊断的敏感性和阴性预测值，而特异性和阳性预测值没有明显降低。然而，我们的结果也表明，FFPE 基础 FISH 不能有效地识别刷检基础 FISH 的假阴性。
我们认为 FISH 可以有效地区分细胞学或影像学怀疑恶性肿瘤的真阳性和假阳性结果。然而，FFPE 基础 FISH 仍然不能准确识别刷检基础 FISH 的假阴性。细胞学和 FFPE 基础 FISH 在某些标本中都有局限性。
