Primary sclerosing cholangitis: detection of cancer in strictures
1Johns Hopkins University, 1650 Orleans Street, Baltimore, MD 21231, USA. rschulick@jhmi.edu
Abstract:
Primary sclerosing cholangitis (PSC) is a significant risk factor for developing cholangiocarcinoma. Tests currently used to screen patients with PSC include serum tumor markers, invasive biliary imaging and sampling techniques, and noninvasive biliary imaging. The most commonly used serum markers are carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA). Invasive biliary imaging includes endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC). In addition to standard cytology, the bile can be tested for CA 19-9 levels, as well as other novel tumor markers. In addition, the brushed cells can be analyzed for chromosomal abnormalities using digital image analysis (DIA) or fluorescence in situ hybridization (FISH). Nonivasive imaging techniques include computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP), and positron emission tomography (PET).
Related Concept Videos
Esophageal Strictures-I: Introduction
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...

