Anybody with experience with FISH testing to detect Cholangiocarcinoma?

My husbands gastro/hep doctors are suggesting to go this route as a next step. There is a mystery concerning the right lobe of liver. They would like to get some tissue samples using the FISH technique to see if there is any CC (cholangiocarcinoma) which would help to get me on a transplant list sooner than later. Just found out too that you have to go to a center that deals with liver cancer rather than a center that just does liver transplants for non-cancer purposes like PSC and cirrhosis. S**t.


FISH: Fluorescence in situ hybridization, a molecular cytogenetic technique that tags genetic material with fluorescent molecules.

FISH is useful for identifying chromosomes and parts of chromosomes, deciphering chromosome rearrangements, detecting chromosome abnormalities, and detecting and mapping genes.

I know a little bit of FISH. It's nothing new and just one method of in situ hybridization. Essentially, you get a tissue sample and make it to slices. Then you apply a labelled complementary RNA or DNA segment (probe) to the tissue slice. If there is a match, then labelled segment will bind to the corresponding segment in that tissue. Next step, you just need to detect that label. Old times, we use radio-active molecule-labelled probe. In FISH, that label is a fluorescence dye. You can see that easily under microscope. It's all from my memory, may not be all correct. But the key principle is correct for sure.

So FISH is not to be used to collect the tissue sample. It's a method to detect certain genetic information from a tissue sample. Then, I would ask two questions to your drs. 1) How you get the right tissue sample at the right spot?. 2) What are to be detected by FISH, i.e. what kind of RNA/DNA pieces are you looking for? How is the specificity (low false positive detection - low false alarm) and sensitivity (low false negative detection - won't miss the diagnosis) of the test? Or simply how reliable and valuable is the test? Usually this method is very sensitive, meaning they can find it if there is only a little bit abnormality. However, how useful is that information is always an issue.

I hope it helps.