FISH + Cytology Beats Cytology Alone for Neoplasia Detection

More sensitive detection in samples from endoscopic ultrasound-guided fine-needle aspiration

FRIDAY, May 4 (HealthDay News) -- For patients with diverse pathologies who undergo endoscopic ultrasonography with fine-needle aspiration, adding fluorescence in situ hybridization (FISH) detection methods to conventional cytology improves the sensitivity of cytology alone for detection of neoplastic lesions, according to a study published in the May issue of Gastroenterology.

To compare the accuracy of conventional cytology with that achieved using digital image analysis and FISH methods to detect neoplasia, Michael J. Levy, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues conducted a prospective study using at least six fine-needle aspiration samples from each of 250 patients, collected during endoscopic ultrasonography.

The researchers tested samples collected from the lymph nodes, pancreas, gastrointestinal lumen wall, periluminal mass, liver, and other miscellaneous sites. Digital image analysis demonstrated a potential lack of utility. FISH combined with conventional cytology was 11 percent more sensitive than cytology alone in detecting malignancy (P = 0.0002), but its specificity was reduced from 100 to 96 percent.

"FISH analysis significantly enhanced the diagnostic sensitivity over conventional cytology alone, despite limited tissue sampling," the authors write. "Our data support the contention that the majority of tested cancers harbor chromosomal alterations, irrespective of the underlying histology."

One author and affiliation disclosed holding a patent and receiving royalties from the sale of the FISH probe set (UroVysion) discussed in this study.

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