Assessment of nuclear nanomorphology marker to improve the detection of malignancy from bile duct biopsy specimens.
The accurate diagnosis of malignancy from small bile duct biopsy specimens is often challenging. This proof-of-concept study assessed the feasibility of a novel optical technology, spatial-domain low-coherence quantitative phase microscopy (SL-QPM), that assesses nanoscale structural alterations in epithelial nuclei for improving the diagnosis of malignancy in bile duct biopsy specimens.



The SL-QPM analysis was performed on standard histology specimens of bile duct biopsy specimens from 45 patients. We analyzed normal cells with benign follow-up, histologically normal cells with pancreaticobiliary malignancy, and malignant epithelial cells.



The SL-QPM-derived nuclear nanomorphology marker can not only distinguish benign and malignant epithelial cells but can also detect features of malignancy in those cells normal by light microscopy with a discriminatory accuracy of 0.90. When combining pathology with SL-QPM, the sensitivity is improved to 88.5% from 65.4% of conventional pathology, while maintaining 100% specificity.



SL-QPM-derived nuclear nanomorphology markers represent a novel approach for detecting malignancy from histologically normal-appearing epithelial cells, with potential as an adjunctive test in patients with negative or inconclusive pathologic diagnosis on bile duct biopsy specimens.
From the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA; hartmandj@upmc.edu.
Douglas J
DJ
Hartman
Department of Pathology, Emory University, Atlanta, GA;
Alyssa M
AM
Krasinskas
Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, PA; and.
Shikhar
S
Uttam
Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, PA; and.
Kevin
K
Staton
Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, PA; and.
Rajan
R
Bista
Department of Gastroenterology, Mayo Clinic, Rochester, MN.
Sumera
S
I Ilyas
Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, PA; and.
Adam
A
Slivka
Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, PA; and.
Randall
R
Brand
Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, PA; and.
Yang
Y
Liu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000473:pathology*; D001652:Bile Ducts / Q000473:pathology*; D014408:Biomarkers, Tumor; D001706:Biopsy; D002467:Cell Nucleus / Q000473:pathology; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D049329:Nanostructures; D012680:Sensitivity and Specificity; D055815:Young Adult
D014408:Biomarkers, Tumor
Gastrointestinal; Molecular diagnostics; Technique