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New Tests to Detect Bile Duct and Pancreatic Cancers from Mayo Clinic
Researchers have developed new tests that double the ability to detect bile duct and pancreatic cancers, according to a Mayo Clinic study published in the June issue of Gastroenterology.
Pancreatobiliary tumors such as bile duct cancer (cholangiocarcinoma) and pancreatic cancer often present as strictures, or a narrowing of the duct that can either be caused by benign inflammation or cancer. Physicians insert an endoscope down the throat and into the bile duct and pancreas region to examine possible tumors; however, the narrowness of the bile duct makes it difficult to distinguish benign and malignant strictures.
In this study, 498 patients with pancreatobiliary duct narrowing underwent an endoscopic procedure, and cell brushings were taken. Brushings were then analyzed by routine cytology, digital image analysis and fluorescence in situ hybridization (FISH) to determine the various tests' effectiveness and sensitivity in detecting and diagnosing cancer. While traditional cytology analysis relies on identifying abnormally shaped cells, the FISH test detects malignant cells using colored probes visible with a fluorescence microscope. Since cancer cells have an abnormal amount of DNA, by FISH these cells show extra copies of the probes compared to normal cells. The Mayo research team found that the combination of cytology and FISH raised the detection rate of bile duct and pancreatic cancer from 20 percent to 43 percent. "Bile duct and pancreatic cancers are very difficult to diagnose," says Lewis Roberts, M.B.Ch.B., Ph.D., Mayo Clinic gastroenterologist and the study's senior author.
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