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Titolo:
Clinical value of K-ras codon 12 analysis and endobiliary brush cytology for the diagnosis of malignant extrahepatic bile duct stenosis
Autore:
Sturm, PDJ; Rauws, EAJ; Hruban, RH; Caspers, E; Ramsoekh, TB; Huibregtse, K; Noorduyn, LA; Offerhaus, GJA;
Indirizzi:
UnivsAmsterdam, Acad Med Ctr, Dept Pathol, NL-1105 AZ Amsterdam, Netherland Univ Amsterdam Amsterdam Netherlands NL-1105 AZ AZ Amsterdam, Netherland Univherlandsam, Acad Med Ctr, Dept Gastroenterol, NL-1105 AZ Amsterdam, Net Univ Amsterdam Amsterdam Netherlands NL-1105 AZ L-1105 AZ Amsterdam, Net Johns Hopkins Med Inst, Dept Pathol, Baltimore, MD 21205 USA Johns HopkinsMed Inst Baltimore MD USA 21205 ol, Baltimore, MD 21205 USA Johns Hopkins Med Inst, Dept Oncol, Baltimore, MD 21205 USA Johns Hopkins Med Inst Baltimore MD USA 21205 ol, Baltimore, MD 21205 USA
Titolo Testata:
CLINICAL CANCER RESEARCH
fascicolo: 3, volume: 5, anno: 1999,
pagine: 629 - 635
SICI:
1078-0432(199903)5:3<629:CVOKC1>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
POLYMERASE CHAIN-REACTION; PANCREATIC-CANCER; ONCOGENE ACTIVATION; GENE MUTATION; POINT MUTATIONS; ADENOCARCINOMA; JUICE; CARCINOMAS; LESIONS; BILIARY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: Offerhaus, GJA Univrdam,erdam, Acad Med Ctr, Dept Pathol, Meibergdreef 9, NL-1105 AZ Amste Univ Amsterdam Meibergdreef 9 Amsterdam Netherlands NL-1105 AZ
Citazione:
P.D.J. Sturm et al., "Clinical value of K-ras codon 12 analysis and endobiliary brush cytology for the diagnosis of malignant extrahepatic bile duct stenosis", CLIN CANC R, 5(3), 1999, pp. 629-635

Abstract

Extrahepatic biliary stenosis can be caused by benign and malignant disorders. In most cases, a tissue diagnosis is needed for optimal management of patients, but the sensitivity of biliary cytology for the diagnosis of a malignancy is relatively low. The additional diagnostic value of K-ras mutational analysis of endobiliary brush cytology was assessed. Endobiliary brushcytology specimens obtained during endoscopic retrograde cholangiopancreaticography were prospectively collected from 312 consecutive patients with extrahepatic biliary stenosis. The results of conventional light microscopiccytology and K-ras codon 12 mutational analysis were compared and evaluated in view of the final diagnosis made by histological examination of the stenotic lesion and/or patient follow-up. The sensitivities of cytology and mutational analysis to detect malignancy were 36 and 42%, respectively. Whenboth tests were combined, the sensitivity increased to 62%. The specificity of cytology was 98%, and the specificity of the mutational analysis and of both tests combined was 89%. Positive predictive values for cytology, mutational analysis, and both tests combined were 98, 92, and 94%, whereas thecorresponding negative predictive values were 34, 34, and 44%, respectively. The sensitivity of K-ras mutational analysis was 63% for pancreatic carcinomas compared to 27% for bile duct, gallbladder, and ampullary carcinomas. K-ras mutational analysis can be considered supplementary to conventionallight microscopy of endobiliary brush cytology to diagnose patients with malignant extrahepatic biliary stenosis, particularly in the case of pancreatic cancer. The presence of a K-ras codon 12 mutation in endobiliary brush cytology per se supports a clinical suspicion of malignancy, even when the conventional cytology is negative or equivocal.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 00:25:11