COMMENTARY

Pancreatobiliary malignancies

Molecular diagnosis of pancreatobiliary malignancies in brush cytologies of biliary strictures

T M Gress

Correspondence to:
Correspondence to:
Professor T M Gress
Department of Internal Medicine I, University Hospital of Ulm, Robert Koch Str 8, 89081 Ulm, Germany; thomas.gress@medizin.uni-ulm.de

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Do molecular techniques improve the diagnostic accuracy of brush cytologies of biliary strictures?

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Keywords: pancreatic cancer; bile duct cancer; loss of heterozygosity; k-ras; molecular diagnostics

The first 150 words of the full text of this article appear below.

Accurate diagnosis of strictures involving the bile duct is essential to the planning of therapy and the choice of the right treatment option, such as surgical resection or endoscopic stenting. However, differentiation of malignant from benign ductal lesions at endoscopic retrograde cholangiopancreatography (ERCP) remains a challenge. Although cholangiographic features may be characteristic for malignant or benign disease, in many cases histological or cytological proof of the diagnosis is required to determine the optimal treatment for each individual patient. Histological and cytological tissue diagnoses may be obtained by several methods, including open biopsy, ultrasound or computed tomography guided fine needle aspiration or core biopsy, endoscopic forceps biopsy, endoscopic brush cytology, and bile aspiration cytology.^1–4

Brush cytology performed at ERCP has become the preferred initial method of pursuing tissue diagnosis in many patients with pancreatobiliary strictures.^5–9 The technique allows easy and convenient sampling and has a low complication rate.^3,9,10 The . . . [Full text of this article]

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