The efficacy of bile liquid biopsy in the diagnosis and treatment of biliary tract cancer

IF 3.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-03-24 DOI:10.1002/jhbp.1432

Yoshifumi Miura, Hiroshi Ohyama, Rintaro Mikata, Yosuke Hirotsu, Kenji Amemiya, Hitoshi Mochizuki, Junichiro Ikeda, Masayuki Ohtsuka, Naoya Kato, Masao Omata

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Abstract

Background

Diagnosing biliary tract cancer is difficult because endoscopic retrograde cholangiopancreatography (ERCP) is performed fluoroscopically, and the sensitivity of bile cytology is low. Liquid biopsy of bile using targeted sequencing is expected to improve diagnosis and treatment, but few studies have been conducted. In this study, we examined whether liquid biopsy of bile improves the diagnostic sensitivity of biliary strictures.

Methods

A total of 72 patients with biliary strictures who underwent ERCP at Chiba University Hospital between April 2018 and March 2021 were examined. Of these, 43 and 29 were clinically and pathologically diagnosed as having malignant and benign biliary strictures, respectively. We performed targeted sequencing of bile obtained from these patients, and the sensitivity of this method was compared with that of bile cytology. Detection of at least one oncogenic mutation was defined as having malignancy.

Results

The sensitivity of bile cytology was 27.9%, whereas that of genomic analysis was 46.5%. Comparing bile cytology alone with the combination of cytology and genomic analysis, the latter was more sensitive (53.5%, p < .001). Among the 43 patients with malignant biliary strictures, mutations with FDA-approved drugs were detected in 11 (26%).

Conclusions

Liquid biopsy of bile can potentially diagnose malignancy and detect therapeutic targets.

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胆汁液体活检在诊断和治疗胆道癌中的疗效。

背景：由于内镜逆行胰胆管造影术（ERCP）是在透视下进行的，而胆汁细胞学检查的灵敏度较低，因此诊断胆道癌十分困难。使用靶向测序技术进行胆汁液体活检有望改善诊断和治疗，但相关研究很少。在这项研究中，我们探讨了胆汁液体活检是否能提高胆道狭窄的诊断敏感性：共检查了 2018 年 4 月至 2021 年 3 月期间在千叶大学医院接受 ERCP 的 72 例胆道狭窄患者。其中，43 例和 29 例分别被临床和病理诊断为恶性和良性胆道狭窄。我们对这些患者的胆汁进行了靶向测序，并将这种方法的灵敏度与胆汁细胞学进行了比较。检测到至少一种致癌突变即被定义为恶性肿瘤：胆汁细胞学的灵敏度为 27.9%，而基因组分析的灵敏度为 46.5%。将单独的胆汁细胞学检查与细胞学检查和基因组分析相结合进行比较，后者的灵敏度更高（53.5%，P 结论：胆汁细胞学检查的灵敏度和基因组分析的灵敏度均高于单独的胆汁细胞学检查：胆汁液体活检可诊断恶性肿瘤并发现治疗靶点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.