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©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 7, 2017; 23(33): 6147-6154
Published online Sep 7, 2017. doi: 10.3748/wjg.v23.i33.6147
Published online Sep 7, 2017. doi: 10.3748/wjg.v23.i33.6147
Suspicious brush cytology is an indication for liver transplantation evaluation in primary sclerosing cholangitis
Sonja Boyd, Johanna Arola, Department of Pathology, University of Helsinki and Helsinki University Hospital, HUSLAB, 00029 Helsinki, Finland
Marko Vannas, Helena Isoniemi, Heikki Mäkisalo, Transplantation and Liver Surgery Clinic, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland
Kalle Jokelainen, Martti A Färkkilä, Clinic of Gastroenterology, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland
Author contributions: Boyd S and Vannas M collected the data; Boyd S prepared figures, wrote the first draft of the manuscript and analysed the data; Vannas M participated in the writing of the manuscript; Jokelainen K, Isoniemi H and Mäkisalo H provided clinical advice; Färkkilä MA and Arola J designed the research and supervised the report; Jokelainen K, Isoniemi H, Mäkisalo H, Färkkilä MA and Arola J revised the manuscript.
Supported by the Sigrid Jusélius Foundation ; the Gastroenterological Research Foundation ; and State Funding for University-level Health Research from the Helsinki University Hospital .
Institutional review board statement: The Ethical committee of Helsinki University Hospital approved this study (Dnro 278/13/03/01/09).
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sonja Boyd, MD, Department of Pathology, Helsinki University Hospital, HUSLAB, PB 400, 00029 Helsinki, Finland. sonja.boyd@hus.fi
Telephone: +358-50-4270551 Fax: +358-9-47175372
Received: February 21, 2017
Peer-review started: February 22, 2017
First decision: March 16, 2017
Revised: April 16, 2017
Accepted: June 18, 2017
Article in press: June 19, 2017
Published online: September 7, 2017
Peer-review started: February 22, 2017
First decision: March 16, 2017
Revised: April 16, 2017
Accepted: June 18, 2017
Article in press: June 19, 2017
Published online: September 7, 2017
Core Tip
Core tip: We investigated markers of high-grade dysplasia for the optimal timing of early liver transplantation (LT) in patients with primary sclerosing cholangitis (PSC). PSC patients in our unit undergo surveillance with endoscopic retrograde cholangiography (ERC) and brush cytology (BC) to identify evidence of dysplasia before progression to cholangiocarcinoma. Carbohydrate antigen 19-9 was higher in patients with cholangiocarcinoma, but no other differences between laboratory values, ERC scores, BC or ploidy analysis between the low-grade, high-grade or CCA groups were observed. Repeated suspicion of neoplasia in BC should be an indication for the evaluation for LT prior to the development of cholangiocarcinoma.