ANALYSIS OF MICRORNA EXPRESSION IN BRUSH CYTOLOGY SPECIMENS IMPROVES THE DIAGNOSIS OF PANCREATOBILIARY CANCER

N Le; J Fillinger; S Szanyi; B Wichmann; ZB Nagy; G Ivády; M Burai; Á Tarpay; J Pozsár; Á Pap; B Molnár; O Csuka; M Bak; Z Tulassay; R Szmola

doi:10.1055/s-0038-1637153

Endoscopy, Inhaltsverzeichnis

Endoscopy 2018; 50(04): S42
DOI: 10.1055/s-0038-1637153

ESGE Days 2018 oral presentations

20.04.2018 – ERCP 2: bile duct stenosis

Georg Thieme Verlag KG Stuttgart · New York

ANALYSIS OF MICRORNA EXPRESSION IN BRUSH CYTOLOGY SPECIMENS IMPROVES THE DIAGNOSIS OF PANCREATOBILIARY CANCER

Autoren

N Le

¹National Institute of Oncology, Department of Interventional Gastroenterology, Budapest, Hungary
J Fillinger

²National Institute of Oncology, Department of Cytopathology, Budapest, Hungary
S Szanyi

¹National Institute of Oncology, Department of Interventional Gastroenterology, Budapest, Hungary
B Wichmann

³Hungarian Academy of Sciences, Molecular Medicine Research Group, Budapest, Hungary
ZB Nagy

⁴Semmelweis University, Molecular Gastroenterology Laboratory, 2nd Department of Internal Medicine, Budapest, Hungary
G Ivády

²National Institute of Oncology, Department of Cytopathology, Budapest, Hungary
M Burai

¹National Institute of Oncology, Department of Interventional Gastroenterology, Budapest, Hungary
Á Tarpay

¹National Institute of Oncology, Department of Interventional Gastroenterology, Budapest, Hungary
J Pozsár

¹National Institute of Oncology, Department of Interventional Gastroenterology, Budapest, Hungary
Á Pap

¹National Institute of Oncology, Department of Interventional Gastroenterology, Budapest, Hungary
B Molnár

⁴Semmelweis University, Molecular Gastroenterology Laboratory, 2nd Department of Internal Medicine, Budapest, Hungary
O Csuka

⁵National Institute of Oncology, Department of Pathogenetics, Budapest, Hungary
M Bak

²National Institute of Oncology, Department of Cytopathology, Budapest, Hungary
Z Tulassay

⁴Semmelweis University, Molecular Gastroenterology Laboratory, 2nd Department of Internal Medicine, Budapest, Hungary
R Szmola

¹National Institute of Oncology, Department of Interventional Gastroenterology, Budapest, Hungary

Abstract

Volltext

Aims:

Malignant pancreatobiliary strictures are in many cases clinically indistinguishable and present a major problem to endoscopy specialists. Intraductal sampling procedures such as brush cytology are commonly used for diagnosis with a sensitivity that is low for a diagnostic test used in daily clinical practice. MicroRNA (miR) alterations detected in many cancers are disease-specific, which can be utilized in clinical applications. The aim of the present study was to analyze whether determination of miR expression levels in intraductal brush cytology specimens is a feasible approach to improve the diagnosis of pancreatobiliary cancer.

Methods:

Brush cytology specimens have been collected during endoscopic retrograde cholangio-pancreatography (ERCP) prospectively (n = 73) and analyzed by routine cytology and ancillary miR assays. Total RNA was extracted using the miRNeasy Mini Kit and the expression of miRs frequently dysregulated in pancreatobiliary cancer (miR-16, miR-21, miR-196a, miR-221) were analyzed by quantitative real-time PCR using RNU6B as internal control.

Results:

Routine cytology resulted in no false positive diagnoses, however, the combined sensitivity remained at 53.3% (n = 16/30). Expression (ΔCt values) of miR-16 (p = 0.0039), miR-196a (p = 0.0003) and miR-221 (p = 0.0049) showed a clear statistical significance between malignant and benign pancreatobiliary specimens (n = 35). Malignancy could be detected combining routine cytology and the miR-196a single marker expression levels with a sensitivity of 84.6% (92.9% in biliary strictures) with no false positives.

Conclusions:

The results offer the first direct demonstration that microRNAs are readily detectable in brush cytology specimens obtained during ERCP, and have the potential to significantly improve the cytological diagnosis of pancreatobiliary malignancy.