Diagnostic Accuracy Performance of Fluorescence In Situ Hybridization (FISH) for Biliary Strictures: A Systematic Review and Meta-Analysis

被引:0
|
作者
Aggarwal, Manik [1 ]
Simadibrata, Daniel M. [1 ]
Kipp, Benjamin R. [2 ]
Prokop, Larry J. [3 ]
Barr Fritcher, Emily G. [2 ]
Schneider, Amber [2 ]
Cooley, Matthew A. [4 ]
Gores, Gregory J. [1 ]
Eaton, John [1 ]
Roberts, Lewis R. [1 ]
Chandrasekhara, Vinay [1 ]
机构
[1] Mayo Clin, Div Gastroenterol & Hepatol, 200,First St SW, Rochester, MN 55905 USA
[2] Mayo Clin, Dept Lab Med & Pathol, Rochester, MN 55905 USA
[3] Mayo Clin, Dept Lib Serv, Rochester, MN 55905 USA
[4] Mayo Clin, Grad Sch Biomed Sci, Rochester, MN 55905 USA
关键词
fluorescence in situ hybridization; biliary stricture; diagnostic accuracy; meta-analysis; PRIMARY SCLEROSING CHOLANGITIS; ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY; CYTOLOGY; CHOLANGIOCARCINOMA; SENSITIVITY; POLYSOMY; JAUNDICE;
D O I
10.3390/jcm13216457
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background and Aims: This systematic review and meta-analysis aims to compare the performance of UroVysion (R) FISH based on the different definitions of a positive result used in published literature with the goal of determining the optimal FISH definition for detecting pancreaticobiliary malignancy. Methods: A systematic literature search identified studies from database inception to Sept 2024 that evaluated the diagnostic performance of FISH in determining malignancy among patients with biliary strictures. All thresholds for positive FISH, as defined by the individual study, were included in this review. Subgroup analysis was performed based on the definitions of positive FISH as follows: (1) polysomy only; (2) polysomy, tetrasomy, or trisomy; and (3) polysomy or 9p deletion. Results: Eighteen studies comprising 2516 FISH specimens were analyzed, including 1133 (45.0%) with malignancy. Using a threshold for positivity as defined in individual studies, the overall sensitivity of FISH was 57.6% (95% confidence interval [CI], 49.4-65.4%), and the overall specificity was 87.8% (95% CI, 79.2-93.2%). Subgroup analysis showed that polysomy as the threshold for positive FISH yielded a sensitivity of 49.4% (95% CI, 43.2-55.5%), with an increased specificity of 96.2% (95% CI, 92.7-98.1%), while polysomy + tetrasomy/trisomy as positive FISH resulted in an increased sensitivity of 64.3% (95% CI 55.4-72.2%) but a decreased specificity of 78.9% (95% CI 64.4-88.5%). The addition of 9p deletion to polysomy as the criteria for a positive test resulted in a non-significant increase in sensitivity (54.7% (95% CI 42.4-66.5%) while maintaining specificity (95.1% (95% CI 84.0-98.6%). Conclusions: Based on these findings, polysomy only or polysomy/9p deletion should be considered as the criterion for defining a positive FISH test to improve diagnostic sensitivity while maintaining high specificity.
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页数:14
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