In situ hybridization for telomerase RNA in routine cytologic brushings for the diagnosis of pancreaticobiliary malignancies.
BACKGROUND
Brush cytology for the diagnosis of pancreaticobiliary malignancy has an overall sensitivity of 50%. Accurate and specific markers are therefore needed for the optimal evaluation of pancreaticobiliary strictures. Telomerase activity is present in 85% to 90% of all human cancers. We sought to determine the utility of in situ hybridization for telomerase RNA in endoscopic brushings for the diagnosis of pancreaticobiliary malignancy.


METHODS
Endoscopic brushings from 18 patients with pancreatic or biliary strictures were evaluated by routine cytology and in situ hybridization for telomerase RNA.


RESULTS
Eight of 18 strictures were malignant. Cytology was positive in 5 patients, whereas telomerase RNA was positive in 6. All malignancies were diagnosed by either cytology or telomerase RNA; however, both studies were positive in only 3. There were no false-positive results by either technique.


CONCLUSIONS
The detection of telomerase RNA in endoscopic brushings may be an important adjunct to cytology for cancer diagnosis in pancreaticobiliary strictures.
Morales
C P
CP
Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas 75235-9039, USA.
Burdick
J S
JS
Saboorian
M H
MH
Wright
W E
WE
Shay
J W
JW
D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000175:diagnosis*; D001652:Bile Ducts / Q000201:enzymology / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D017403:In Situ Hybridization; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000201:enzymology / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D012313:RNA / Q000032:analysis*; D019098:Telomerase / Q000032:analysis* / Q000235:genetics
D012313:RNA; D019098:Telomerase