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

N Le
1   National Institute of Oncology, Department of Interventional Gastroenterology, Budapest, Hungary
,
J Fillinger
2   National Institute of Oncology, Department of Cytopathology, Budapest, Hungary
,
S Szanyi
1   National Institute of Oncology, Department of Interventional Gastroenterology, Budapest, Hungary
,
B Wichmann
3   Hungarian Academy of Sciences, Molecular Medicine Research Group, Budapest, Hungary
,
ZB Nagy
4   Semmelweis University, Molecular Gastroenterology Laboratory, 2nd Department of Internal Medicine, Budapest, Hungary
,
G Ivády
2   National Institute of Oncology, Department of Cytopathology, Budapest, Hungary
,
M Burai
1   National Institute of Oncology, Department of Interventional Gastroenterology, Budapest, Hungary
,
Á Tarpay
1   National Institute of Oncology, Department of Interventional Gastroenterology, Budapest, Hungary
,
J Pozsár
1   National Institute of Oncology, Department of Interventional Gastroenterology, Budapest, Hungary
,
Á Pap
1   National Institute of Oncology, Department of Interventional Gastroenterology, Budapest, Hungary
,
B Molnár
4   Semmelweis University, Molecular Gastroenterology Laboratory, 2nd Department of Internal Medicine, Budapest, Hungary
,
O Csuka
5   National Institute of Oncology, Department of Pathogenetics, Budapest, Hungary
,
M Bak
2   National Institute of Oncology, Department of Cytopathology, Budapest, Hungary
,
Z Tulassay
4   Semmelweis University, Molecular Gastroenterology Laboratory, 2nd Department of Internal Medicine, Budapest, Hungary
,
R Szmola
1   National Institute of Oncology, Department of Interventional Gastroenterology, Budapest, Hungary
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Publikationsverlauf

Publikationsdatum:
27. März 2018 (online)

 
 

    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.


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