Biliary Tract Malignancy

Factors That Influence Sensitivity Of Cytology Specimens

September 2011

Thank you, Dr. Gores. As Dr. Gores explained, the Mayo Clinic Molecular Cytology laboratory currently performs 2 tests to help determine if a patient has a pancreatobiliary malignancy and they are conventional cytology and FISH testing. I will explain how this testing is performed and interpreted in more detail in the coming slides but before I do that I want to mention that factors that can influence the sensitivity, specificity, and positive and negative predictive value of these tests include sampling error, interpretation error, and the clinical scenario. With regard to sampling, the cytology and FISH tests require that the neoplastic cells be present in the specimen for the tests to be able to detect the tumor. Consequently, false-negative results can result if the brush does not adequately sample the lesion.

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Jump to section:

• Introduction
• Disclosures
• Pancreatobiliary Strictures (PBS)
• Primary Sclerosing Cholangitis (PSC)
• Pancreatobiliary Strictures (PBS)
• Bile Duct Brushings
• Current Clinical Practice
• Factors That Influence Sensitivity Of Cytology Specimens
• Routine Cytology
• Cancer Is A Genetic Disorder That Results From Mutations
• Detecting Tumor Cells in Cytology Specimens Using FISH
• Types of FISH Probes
• FISH
• Sensitivity and Specificity of Various Tests for Detection of Pancreatobiliary Strictures Malignancy
• What Do We Do With These Data?
• Bile Duct Pathology Calculator
• Representative Test Report Using Bile Duct Calculator
• Bile Duct Calculator
• Impact of Disease Prevalence on Positive Predictive Value (PPV)
• Case 1
• Case 1 Cytologic Findings
• Case 1
• Case 1 Test Report Using Bile Duct Calculator
• Case 1
• Case 1
• Case 2
• Case 2 Cytologic Findings
• Case 2
• Case 2: Test Report Using Bile Duct Calculator
• Case 2
• Case 2
• Case 3
• Case 3 Cytologic Findings
• Case 3
• Case 3
• Case 3: Test Report Using Bile Duct Calculator
• Case 3
• Case 3
• Summary
• Summary
• Results
• Questions?