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The Detection of Cholangiocarcinoma in Primary Sclerosing Cholangitis Patients: Single Center Experience

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Abstract

Purpose

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).

Conclusion

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.

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Authors and Affiliations

  1. Department of Gastroenterology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey

    Ufuk Barış Kuzu, Bülent Ödemiş, Nuretdin Suna, Hakan Yıldız, Erkan Parlak, Selçuk Dişibeyaz, Serkan Torun, Muhammet Yener Akpınar, Orhan Coşkun, Mahmut Yüksel & Ertuğrul Kayaçetin

  2. Department of Pathology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey

    Nesrin Turhan

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  1. Ufuk Barış Kuzu
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Kuzu, U.B., Ödemiş, B., Suna, N. et al. The Detection of Cholangiocarcinoma in Primary Sclerosing Cholangitis Patients: Single Center Experience. J Gastrointest Canc 47, 8–14 (2016). https://doi.org/10.1007/s12029-015-9777-1

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