{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T10:48:03Z","timestamp":1774262883898,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2011,11,15]],"date-time":"2011-11-15T00:00:00Z","timestamp":1321315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Detection of biliary dysplasia in <jats:styled-content style=\"fixed-case\">PSC<\/jats:styled-content> is essential for proper timing of liver transplantation to prevent the development of cholangiocancer, which is considered a contraindication for liver transplantation in most centres. In patients with <jats:styled-content style=\"fixed-case\">PSC<\/jats:styled-content>, differential diagnosis of benign, premalignant and malignant biliary strictures is difficult.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This prospective study aimed to evaluate the role of <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> analysis in combination with brush cytology, scored <jats:styled-content style=\"fixed-case\">ERCP<\/jats:styled-content> findings, and tumour markers to detect hepatobiliary dysplasia and malignancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Brush samples for cytology and for evaluation of <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> content analysed with flow cytometry came from 102 consecutive <jats:styled-content style=\"fixed-case\">PSC<\/jats:styled-content> patients referred for <jats:styled-content style=\"fixed-case\">ERCP<\/jats:styled-content>. Symptoms, serum Ca19\u20109 and <jats:styled-content style=\"fixed-case\">CEA<\/jats:styled-content> were determined at the time of index biliary examination. <jats:styled-content style=\"fixed-case\">ERCP<\/jats:styled-content> findings were scored for intra\u2010 and extrahepatic changes. The end\u2010points were liver transplantation or diagnosis of malignancy or dysplasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most of the patients were asymptomatic at the time of <jats:styled-content style=\"fixed-case\">ERCP<\/jats:styled-content>: 73% had no symptoms, and 12% had only mild symptoms. An aneuploid <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> content was evident in 20 (20%) patients, and cells suspected for malignancy in 22 (21%). Seven patients had both aneuploidity and cytology (7%) suspicious for malignancy. An end\u2010point, diagnosis of malignancy or liver transplantation was achieved in 42 patients. Combining <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> ploidity and cytology in patients at the end\u2010point, sensitivity was 72%, specificity 82%, positive predictive value 86% and negative predictive value 67%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and conclusion<\/jats:title><jats:p>In this mostly asymptomatic <jats:styled-content style=\"fixed-case\">PSC<\/jats:styled-content>\u2010patient population, 33% demonstrated abnormal brush cytology or aneuploidity. Determining <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> ploidy and brush cytology during <jats:styled-content style=\"fixed-case\">ERCP<\/jats:styled-content> offers a useful tool for identifying those <jats:styled-content style=\"fixed-case\">PSC<\/jats:styled-content> patients who are at high risk of developing cholangiocancer.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1478-3231.2011.02672.x","type":"journal-article","created":{"date-parts":[[2011,11,16]],"date-time":"2011-11-16T17:57:28Z","timestamp":1321466248000},"page":"783-789","source":"Crossref","is-referenced-by-count":30,"title":["Biliary dysplasia in patients with primary sclerosing cholangitis: additional value of DNA ploidity"],"prefix":"10.1111","volume":"32","author":[{"given":"Leena","family":"Halme","sequence":"first","affiliation":[{"name":"Department of Gastroenterologic Surgery Helsinki University Hospital Helsinki 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