Molecular Cytology Applications on Pancreas and Biliary Tract
| Autor: | Norge Vergara, Roseann I. Wu, Rene Gerhard |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry Gene mutation Neuroendocrine tumors medicine.disease_cause medicine.disease 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Biliary tract 030220 oncology & carcinogenesis Cytology medicine 030211 gastroenterology & hepatology Radiology KRAS business Pancreas Fluorescence in situ hybridization |
| Zdroj: | Molecular Applications in Cytology ISBN: 9783319749402 |
| DOI: | 10.1007/978-3-319-74942-6_11 |
| Popis: | Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endoscopic retrograde cholangiopancreatography (ERCP) are today’s standard of care methods for obtaining a tissue diagnosis from the pancreatobiliary tract. The cytologic examination of material collected by either EUS-FNA or ERCP is usually sufficient for diagnosing the majority of pathologic conditions associated with the pancreatobiliary system. In addition to the essential role of cytomorphology for patient diagnosis and management, ancillary tests such as immunocytochemistry and molecular testing can be used to support the morphologic impression. Indeed, immunocytochemical stains for pancreatic neuroendocrine tumors, fluorescence in situ hybridization (FISH) for the evaluation of biliary tract strictures, and molecular analysis of KRAS gene mutations to support the diagnosis of pancreatobiliary carcinomas have been accepted as reliable ancillary tests applied to cytologic specimens. However, controversies exist regarding the routine implementation of such tests due to limitations such as the need for a substantial amount of diagnostic material, the labor-intensive and time-consuming nature of some of the techniques, the moderate specificity, difficulties in interpreting the results, and the relative costs of molecular methods. Currently, there is not sufficient clinical evidence to support widespread adoption of most molecular tests. Nevertheless, recent studies and new techniques, such as next-generation sequencing (NGS), could provide more comprehensive knowledge of the molecular landscape of pancreatobiliary tumors that may result in the discovery of biomarkers for future targeted therapies. |
| Databáze: | OpenAIRE |
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