title: The Detection of Cholangiocarcinoma in Primary Sclerosing Cholangitis Patients: Single Center Experience.
abstract: OBJECTIVE
  Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease. Cholangiocarcinoma (CCA) is one of the feared complications of PSC. In our study, we aim to establish the success of brush cytology and CA 19-9 in putting the diagnosis of CCA.
  
  
  METHODS
  The data of 30 PSC patients was retrospectively screened whom had brush cytology performed due to dominant strictures. The definitive diagnosis was established by histopathological examination or via radiological/clinic follow-up for at least 12 months.
  
  
  RESULTS
  A total of four patients were excluded from the study. Twenty-six patients diagnosed with PSC, six of which were also diagnosed with CCA, were included in the study. The sensitivity and the specificity of the brush cytology in the diagnosis of CCA in PSC patients were 66.7 and 95%, respectively. CA 19-9 had high correlation with bilirubin level. The optimal level of CA 19-9 in the diagnosis of CCA was determined to be 138.5 U/ml. Superiority of Ramage scoring over CA 19-9 in the diagnosis of CCA in PSC patients was not established (sensitivity and specificity were 50%, 94.7% and 83.3%, 85%, respectively).
  
  
  CONCLUSIONS
  Brush cytology has moderate sensitivity in differentiating strictures in PSC patients. CA 19-9 has high sensitivity but bilirubin level can affect the CA 19-9. Therefore, advanced techniques and parameters are needed for detecting CCA in PSC patients.
authors.affiliation: Department of Gastroenterology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey. ubarisk@gmail.com.
authors.forename: Ufuk Barış
authors.initials: UB
authors.lastname: Kuzu
authors.affiliation: Department of Gastroenterology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Ödemiş
authors.affiliation: Department of Gastroenterology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey.
authors.forename: Nuretdin
authors.initials: N
authors.lastname: Suna
authors.affiliation: Department of Gastroenterology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Yıldız
authors.affiliation: Department of Gastroenterology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Parlak
authors.affiliation: Department of Gastroenterology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Dişibeyaz
authors.affiliation: Department of Gastroenterology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Torun
authors.affiliation: Department of Gastroenterology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey.
authors.forename: Muhammet Yener
authors.initials: MY
authors.lastname: Akpınar
authors.affiliation: Department of Gastroenterology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Coşkun
authors.affiliation: Department of Pathology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey.
authors.forename: Nesrin
authors.initials: N
authors.lastname: Turhan
authors.affiliation: Department of Gastroenterology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Yüksel
authors.affiliation: Department of Gastroenterology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey.
authors.forename: Ertuğrul
authors.initials: E
authors.lastname: Kayaçetin
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D001653:Bile Ducts, Intrahepatic / Q000378:metabolism / Q000473:pathology*; D015415:Biomarkers / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000097:blood*; D018281:Cholangiocarcinoma / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D015209:Cholangitis, Sclerosing / Q000150:complications*; D003581:Cytodiagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor
keywords: Brush cytology; CA 19-9; Cholangiocarcinoma; Primary sclerosing cholangitis