Triple modality testing by endoscopic retrograde cholangiopancreatography for the diagnosis of XXXX .

@entity1 @entity253 @entity201
OBJECTIVES: Brush cytology has a low sensitivity for the diagnosis of @entity201 . This study aimed to compare the standard approach (brush cytology) with a triple modality approach utilizing brush cytology, forceps biopsy and fluorescence in situ hybridization in terms of sensitivity and specificity for the diagnosis of @entity201 . METHODS: In a retrospective study at a single academic center, 50 @entity1 underwent triple modality testing. Additionally, 61 @entity1 underwent brush cytology alone. Intervention was endoscopic retrograde cholangiopancreatography with brush cytology, fluorescence in situ hybridization, and forceps biopsy. The main outcome measures included sensitivity, specificity, positive predictive value and negative predictive value. RESULTS: Overall, 50 @entity1 underwent triple tissue sampling, and 61 @entity1 underwent brush cytology alone. Twenty-two @entity1 were eventually diagnosed with @entity201 . Brush cytology had a sensitivity of 42%, specificity of 100%, positive predictive value of 100% and negative predictive value of 88%. Triple tissue sampling had an overall sensitivity of 82%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 87%. Within the triple test group, brush cytology had a sensitivity of 27%, forceps biopsy had a sensitivity of 50%, and fluorescence in situ hybridization analysis had a sensitivity of 59%. CONCLUSIONS: A triple modality approach results in a marked increase in sensitivity for the diagnosis of @entity201 compared with single modality testing such as brush cytology and should be considered in the evaluation of indeterminate or suspicious @entity253 .
