A Review of Recent Advances in Cytopathology for Diagnosis of Hepato-Biliary Lesions
Abstract
Cytology has emerged as an important diagnostic modality for hepato-biliary lesions because of its minimally invasive, rapid turnaround time and cost-effective nature. This is especially important in diagnosis of neoplastic pathology of liver, gall bladder or bile duct where biopsy is difficult and delayed diagnosis may lead to complications or even mortality. The advent of newer molecular diagnostic modalities like polymerase chain reaction (PCR), fluorescent in situ hybridization (FISH), immunochemistry or more recently circulating tumour cells and next generation sequencing (NGS) have not only led to precise diagnosis but are also helpful in targeted therapy and prognostication of tumour. Cytology which is a minimally invasive technique can be judiciously used for advanced molecular analysis for diagnosis and management of hepato-biliary lesions. Awareness regarding the use of cytological samples for molecular analysis in hepato- biliary lesions is essential so that mutational changes may be easily determined without undergoing any invasive technique in these deep-seated lesions. It is also necessary that guidelines on molecular cytology should be chalked out so that uniform reporting is followed with maintenance of high-quality standards.References
Selhi PK, Singh Y, Jain S, Kaur H, Sood N. Diagnostic role of fine needle aspiration cytology (FNAC) in the evaluation of gall bladder lesions: an institutional experience. Diagn Cytopathol. 2020. [PMID: 32506819.
Sheefa H, Lata J, Basharat M, Rumana M, Veena M. Utility of FNAC in Conjunction with Cell Block for Diagnosing Space-Occupying Lesion (SOL) of Liver with Emphasis on Differentiating Hepatocellular Carcinoma from Metastatic SOL: Analysis of 61 Cases. Oman Med J. 2016;31:135-41.
Crinò SF, Larghi A, Bernardoni L, Parisi A, Frulloni L, Gabbrielli A, et al. Touch imprint cytology on endoscopic ultrasound fine-needle biopsy provides comparable sample quality and diagnostic yield to standard endoscopic ultrasound fine-needle aspiration specimens in the evaluation of solid pancreatic lesions. Cytopathology. 2019;30:179-186.
Pitman MB, Layfield LJ. Guidelines for pancreaticobiliary cytology from the Papanicolaou Society of Cytopathology: A review. Cancer Cytopathol. 2014;122:399-411.
Zhang S, Yang B. Development and validation of molecular testing on cytologic specimens. In: Yang B, Rao J. Molecular Cytopathology, Essentials in Cytopathology. Switzerland: Springer International Publishing, 2016: 1-16
Ung KA, Ljung A, Wågermark J, et al. Brush cytology is superior to biopsies obtained by a new device in bile duct strictures. Hepatogastroenterology. 2007; 54: 664- 668.
Layfield LJ, Schmidt RL, Hirschowitz SL, Olson MT, Ali SZ, Dodd LL. Significance of the diagnostic categories “atypical” and “suspicious for malignancy” in the cytologic diagnosis of solid pancreatic masses. Diagn Cytopathol. 2014; 42: 292- 296.
Guyard A, Boyez A, Pujals A, Robe C, Tran Van Nhieu J, Allory Y, et al. DNA degrades during storage in formalin-fixed and paraffin-embedded tissue blocks. Virchows Arch. 2017;471:491-500.
Bass BP, Engel KB, Greytak SR, Moore HM. A review of preanalytical factors affecting molecular, protein, and morphological analysis of formalin-fixed, paraffin-embedded (FFPE) tissue: how well do you know your FFPE specimen? Arch Pathol Lab Med. 2014;138:1520-30.
Sotoudeh AM, Gharib A, Abolhasani M, Azari-Yam A, Hossieni GF, Safavi M, et al. Pre-analytical Practices in the Molecular Diagnostic Tests, A Concise Review. Iran J Pathol. 2021;16:1-19.
Aguilar BB, Sancho BP. Laser capture microdissection: techniques and applications in liver diseases. Hepatol Int. 2019;13:138-147.
Makvandi M. Update on occult hepatitis B virus infection. World J Gastroenterol. 2016;22:8720-8734.
Armas CA, Perea HY, González GYJ, Figueredo LJE, Valdivia ÁIY, Gómez CI, et al. Performance characteristics of a fast real-time PCR assay for hepatitis B virus DNA quantification. Biologicals. 2019;58:22-27.
Mohammad RH, Pourhosseingholi MA, Yadegar A, Mirjalali H, Zali MR. High-resolution melt curve analysis: A real-time based multipurpose approach for diagnosis and epidemiological investigations of parasitic infections. Comp Immunol Microbiol Infect Dis. 2019;67:101364.
Mu X, Chen W, Shi J, Li X, Wang Y. Development of a GeXP-Based Multiplex RT-PCR Assay for Detection of Long Noncoding RNA in Hepatocellular Carcinoma. Lab Med. 2019;50:180-188.
Sharma A, Sharma KL, Gupta A, Yadav A, Kumar A. Gallbladder cancer epidemiology, pathogenesis and molecular genetics: Recent update. World J Gastroenterol. 2017;23:3978-3998.
Monaco SE, Dacic S. Fluorescence in situ hybridization in cytopathology. In: Bui MM, Pantanowitz L: Modern Techniques in Cytopathology. Monogr Clin Cytol. Basel: Karger, 2020, 25:19–33
Kang HJ, Haq F, Sung CO, Choi J, Hong SM, Eo SH, et al. Characterization of Hepatocellular Carcinoma Patients with FGF19 Amplification Assessed by Fluorescence in situ Hybridization: A Large Cohort Study. Liver Cancer. 2019;8:12-23.
Zhang X, Yue L, Zhang Z, Yuan Z. Establishment of a fluorescent in situ hybridization assay for imaging hepatitis B virus nucleic acids in cell culture models. Emerg Microbes Infect. 2017;6(11):e98.
Liew ZH, Loh TJ, Lim TKH, Lim TH, Khor CJL, Mesenas SJ, et al. Role of fluorescence in situ hybridization in diagnosing cholangiocarcinoma in indeterminate biliary strictures. J Gastroenterol Hepatol. 2018;33:315-319.
Kushnir VM, Mullady DK, Das K, Lang G, Hollander TG, Murad FM, et al. The diagnostic yield of malignancy comparing cytology, FISH, and molecular analysis of cell free cytology brush supernatant in patients with biliary strictures undergoing endoscopic retrograde cholangiography (ERC): A prospective Study. J Clin Gastroenterol. 2019;53:686-692.
Vyas M, Jain D. A practical diagnostic approach to hepatic masses. Indian J Pathol Microbiol. 2018;61:2-17.
Jain P, Goyal S, Chauhan G, Majumdar K, Ali S, Sakhuja P, et al. HER-2/neu over expression in gall bladder adenocarcinoma: A quest for potential therapeutic target. Indian J Pathol Microbiol. 2020;63:214-220.
Ye Q, Ling S, Zheng S, Xu X. Liquid biopsy in hepatocellular carcinoma: circulating tumor cells and circulating tumor DNA. Mol Cancer. 2019;18:114.
Banales JM, Marin JJG, Lamarca A, Rodrigues PM, Khan SA, Roberts LR, et al. Cholangiocarcinoma 2020: the next horizon in mechanisms and management. Nat Rev Gastroenterol Hepatol. 2020;17:557-588.
Harding JJ, Nandakumar S, Armenia J, Khalil DN, Albano M, Ly M, et al. Prospective Genotyping of Hepatocellular Carcinoma: Clinical Implications of Next-Generation Sequencing for Matching Patients to Targeted and Immune Therapies. Clin Cancer Res. 2019;25:2116-2126.
Copyright (c) 2022 Smita Chandra
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
