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Repeated brush cytology detected abnormalities in primary sclerosing cholangitis patients before liver transplant
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BOSTON — Compared with single brush cytology, repeated brush cytology with or without fluorescence in situ hybridization increased sensitivity and specificity for detecting dysplasia or cholangiocarcinoma in primary sclerosing cholangitis patients prior to liver transplantation, according to data presented at The Liver Meeting.
Researchers sought to compare the efficacy of single vs. repeated brush cytology in detecting dysplasia or cholangiocarcinoma (CCA) in primary sclerosing cholangitis (PSC) patients before liver transplantation. Patients with PSC who underwent liver transplantation (n=255) from 1999-2013 in Sweden were assessed, and were grouped based on presence of CCA or dysplasia determined by explanted liver histopathology.
Single brush cytology was completed before liver transplant in 48 patients and yielded 50% sensitivity and 81% specificity. Repeated brush cytology was carried out in 65 patients and increased sensitivity and specificity to 100% and 83%, respectively. Subgroup analysis in which FISH was used in combination (n=64) demonstrated that finding aneuploidy or abnormalities increased sensitivity from 83% to 95%; When only diploid cells were found, specificity increased from 90% to 95%. Post-transplant survival was lower in patients with undiagnosed CCA (P<.001).
A second sampling using brush cytology increased detection of dysplasia or CCA in PSC patients. This improvement is important, according to the researchers, considering the negative post-transplantation survival rate associated with undiagnosed CCA.
For more information:
Majeed A. Abstract 288. Presented at: The Liver Meeting, Nov. 7-11, 2014; Boston.
Disclosure: The researchers report no relevant financial disclosures.