Correlating routine cytology, quantitative nuclear morphometry by digital image analysis, and genetic alterations by fluorescence in situ hybridization to assess the sensitivity of cytology for detecting pancreatobiliary tract malignancy

Routine cytologic (RC), fluorescence in situ hybridization (FISH), digital image analysis (DIA), and quantifiable morphometric results from 284 pancreatobiliary stricture brushings were compared. We chose specific DIA nuclear features assessed by pathologists in evaluating RC specimens, such as area...

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Bibliographic Details
Published in:American journal of clinical pathology 2007-08, Vol.128 (2), p.272-279
Main Authors: BARR FRITCHER, Emily G, KIPP, Benjamin R, SLEZAK, Jeffrey M, MORENO-LUNA, Laura E, GORES, Gregory J, LEVY, Michael J, ROBERTS, Lewis R, HALLING, Kevin C, SEBO, Thomas J
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Bile Duct Neoplasms - genetics
Bile Duct Neoplasms - pathology
Biological and medical sciences
Cell Nucleus - pathology
Child
Chromosome Aberrations
Female
Humans
Image Processing, Computer-Assisted - methods
In Situ Hybridization, Fluorescence - methods
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Pancreatic Neoplasms - genetics
Pancreatic Neoplasms - pathology
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Sensitivity and Specificity
Trisomy
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Summary:Routine cytologic (RC), fluorescence in situ hybridization (FISH), digital image analysis (DIA), and quantifiable morphometric results from 284 pancreatobiliary stricture brushings were compared. We chose specific DIA nuclear features assessed by pathologists in evaluating RC specimens, such as area and shape. A visual nuclear morphometric score (VNMS) was calculated. There was a difference (P < .001) in the mean VNMS when RC results were classified as negative (11.5), atypical (12.5), suspicious (13.8), and positive (16.5). The mean VNMS of specimens diagnosed as disomy (11.3), trisomy 7 (12.1), and polysomy (14.7) by FISH was also different (P < .001). There was no difference in the VNMS of false-negative and true-negative cytologic specimens (P = .225). Our findings substantiate the relationship between cell nuclear visual alterations and genetic FISH abnormalities. The low sensitivity of cytologic examination for pancreatobiliary carcinoma is due to an absence of tumor cells or the presence of well-differentiated tumor lacking recognizable nuclear atypia.
ISSN:0002-9173
1943-7722
DOI:10.1309/BC6DY755Q3T5W9EE