{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:41:34Z","timestamp":1788432094463,"version":"build-2803163510"},"reference-count":42,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Biliary strictures can be caused by benign and malignant conditions. A biliary duct brushing diagnosis can be challenging because of low cellularity and overlapping morphology among different entities, leading to a variable reported sensitivity. This study aimed to assess the value of <jats:italic>KRAS<\/jats:italic> mutation testing in adding cytological diagnosis of biliary duct brushings.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>With institutional review board approval, biliary duct brushing cytology specimens were collected from 269 patients with extrahepatic biliary stenosis between August 2011 and July 2021. The results of cytology and <jats:italic>KRAS<\/jats:italic> mutational analyses were evaluated in view of corresponding cytology examination and histopathological\/clinical follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p><jats:italic>KRAS<\/jats:italic> mutations were identified in 50 of 269 biliary stricture brushing cases (19%). Among the cases with available follow\u2010up, 72% (34 of 47) of biliary brushings had confirmed malignancy when there were <jats:italic>KRAS<\/jats:italic> mutations. The overall specificity and sensitivity of <jats:italic>KRAS<\/jats:italic> mutation testing was 92% and 36%, respectively. <jats:italic>KRAS<\/jats:italic> mutation was significantly more enriched in pancreatic duct adenocarcinoma than in cholangiocarcinoma (66% vs 5%, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). The absolute risk of malignancy was 3%, 28%, and 71%, respectively, in negative, atypical, and suspicious cytological diagnostic categories and the risks increased to 14%, 68%, and 95% in corresponding categories with <jats:italic>KRAS<\/jats:italic> mutation.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Our results suggested that <jats:italic>KRAS<\/jats:italic> mutational analysis can be considered supplementary to cytology diagnosis of biliary duct brushing for patients with extrahepatic biliary stenosis in clinical practice.;<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.22579","type":"journal-article","created":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T11:15:35Z","timestamp":1649848535000},"page":"558-565","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Significance of <scp><i>KRAS<\/i><\/scp> mutation testing in biliary brushing cytology specimens: A 10\u2010year retrospective review"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7731-9309","authenticated-orcid":false,"given":"Tong","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Pathology Yale University School of Medicine  New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Zuo","sequence":"additional","affiliation":[{"name":"Department of Pathology &amp; Laboratory Medicine Boston University School of Medicine  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Pathology Yale University School of Medicine  New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8725-5940","authenticated-orcid":false,"given":"Guoping","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Pathology 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