{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T03:30:44Z","timestamp":1789615844642,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,4,20]],"date-time":"2014-04-20T00:00:00Z","timestamp":1397952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Digest Diseases"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The management of atypical cells on endoscopic retrograde brush cytology (<jats:styled-content style=\"fixed-case\">ERBC<\/jats:styled-content>) in patients with indeterminate biliary stricture is unclear. This study aimed to investigate the detection of cancer (pancreatic and biliary carcinoma) in patients with atypical cells on <jats:styled-content style=\"fixed-case\">ERBC<\/jats:styled-content> and the factors predicting it.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From a prospectively maintained cytology database in a tertiary care center, patients with indeterminate biliary stricture and atypical cells on <jats:styled-content style=\"fixed-case\">ERBC<\/jats:styled-content> from 1996 to 2012 were studied. The date of the initial <jats:styled-content style=\"fixed-case\">ERBC<\/jats:styled-content> with atypical cells was identified as time zero. The primary outcome was to study the incidences and <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>aplan\u2013<jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>eier estimates for detecting cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 104 patients with 182.8 person\u2010years of follow\u2010up were identified. In 38 (36.5%) patients cancer was detected (19 cholangiocarcinoma, 15 pancreatic cancer, three ampullary cancer and one gallbladder carcinoma) over a mean follow\u2010up of 4.4 months. On Cox regression analysis, the presence of clinical jaundice (hazard ratio [<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>] 4.08, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.41\u201311.8), active alcohol consumption (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 7.33, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.85\u201329.1) and elevated carbohydrate antigen 19\u20109 (<jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content>19\u20109) level (&gt;33 U\/mL) (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 8.42, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.75\u201340.6) at the time of <jats:styled-content style=\"fixed-case\">ERBC<\/jats:styled-content> were associated with increased risk for the detection of cancer. Detection of cancer was more common during the first 6 months of follow\u2010up than at any time period thereafter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Elevated CA19\u20109 level, the presence of clinical jaundice and current alcohol consumption are associated with increased detection of cancer in patients with indeterminate biliary stricture and atypical cells on <jats:styled-content style=\"fixed-case\">ERBC<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1751-2980.12134","type":"journal-article","created":{"date-parts":[[2014,2,12]],"date-time":"2014-02-12T12:50:35Z","timestamp":1392209435000},"page":"268-275","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Predictors for detection of cancer in patients with indeterminate biliary stricture and atypical cells on endoscopic retrograde brush cytology"],"prefix":"10.1111","volume":"15","author":[{"given":"Udayakumar","family":"Navaneethan","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Digestive Disease Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tavankit","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Digestive Disease Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norma G","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Digestive Disease Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramprasad","family":"Jegadeesan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Digestive Disease Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Preethi G","family":"Venkatesh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Digestive Disease Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Brainard","sequence":"additional","affiliation":[{"name":"Cytopathology Pathology and Laboratory Medicine Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J","family":"Vargo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Digestive Disease Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mansour A","family":"Parsi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Digestive Disease Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,4,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(95)70012-9"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(00)70435-4"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(95)70004-8"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00006-0"},{"key":"e_1_2_6_6_1","first-page":"722","article-title":"Benign, dysplastic, or malignant \u2013 making sense of endoscopic bile duct brush cytology: results in 149 consecutive patients","volume":"90","author":"Lee JG","year":"1995","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0339(199704)16:4<358::AID-DC11>3.0.CO;2-J"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2008.07.007"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v17.i1.1"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e3181f3aa96"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2007.04.017"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(89)72767-X"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(94)70156-3"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21842"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.22924"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.20192"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-08-0177"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23267"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alcohol.2005.03.010"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.01796.x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01104.x"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01542654"},{"key":"e_1_2_6_23_1","first-page":"54","article-title":"Reference values and biological variation for tumor marker CA19\u20109 in serum for different Lewis and secretor genotypes and evaluation of secretor and Lewis genotyping in a Caucasian population","volume":"45","author":"Vestergaard EM","year":"1999","journal-title":"Clin Chem"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-012-2401-3"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(12)63538-0"}],"container-title":["Journal of Digestive Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1751-2980.12134","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1751-2980.12134","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T07:58:39Z","timestamp":1696319919000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1751-2980.12134"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,20]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2014,5]]}},"alternative-id":["10.1111\/1751-2980.12134"],"URL":"https:\/\/doi.org\/10.1111\/1751-2980.12134","archive":["Portico"],"relation":{},"ISSN":["1751-2972","1751-2980"],"issn-type":[{"value":"1751-2972","type":"print"},{"value":"1751-2980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,20]]},"assertion":[{"value":"2014-04-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}