Diagnostic efficacy of brush cytology and biopsy forceps under the guidance of endoscopic retrograde cholangiopancreatography to differentiate between benign and malignant biliary strictures
10.3760/cma.j.cn321463-20240124-00225
- VernacularTitle:内镜逆行胰胆管造影术引导下细胞刷刷检与活检钳活检鉴别良恶性胆管狭窄的诊断效能分析
- Author:
Zheng LIANG
1
;
Yongqiu WEI
;
Guo ZHANG
;
Haoxi LIU
;
Jiaxuan ZUO
;
Peng LI
;
Shutian ZHANG
Author Information
1. 首都医科大学附属北京友谊医院消化内科，北京100050
- Keywords:
Cholangiopancreatography, endoscopic retrograde;
Unknown biliary strictures;
Brush cytology;
Biopsy sampling
- From:
Chinese Journal of Digestive Endoscopy
2024;41(11):857-863
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the diagnostic efficacy of brush cytology and transpapillary biopsy sampling under the guidance of endoscopic retrograde cholangiopancreatography (ERCP) in distinguishing between benign and malignant biliary strictures.Methods:A total of 470 patients with unknown biliary strictures who underwent ERCP at Department of Gastroenterology, Beijing Friendship Hospital from January 2013 to January 2022 were enrolled. Brush cytology was performed before biopsy in a single procedure, and with multiple ERCP brush cytologies or biopsy performed for challenging cases. Clinical data, ERCP procedures, pathological results, and follow-up data were collected. With the final diagnosis as the golden standard, the diagnostic efficacy of brush cytology and biopsy sampling were calculated.Results:The final diagnosis showed 251 cases of malignant and 219 cases of benign biliary strictures. All 470 patients received brush cytology, among whom, 37 patients underwent multiple brush cytologies. Additionally, 114 patients were treated with biopsy sampling. The single brush cytology showed a sensitivity of 49.40% (124/251) and a specificity of 99.09% (217/219) for diagnosing malignant biliary strictures. Multiple brush cytologies showed a sensitivity of 68.42% (13/19) and a specificity of 100.00% (18/18). Biopsy sampling showed a sensitivity of 68.18% (45/66) and a specificity of 97.92% (47/48). Among the 114 patients who underwent both brush cytology and biopsy sampling, the results showed that the diagnostic sensitivity of brush cytology combined with biopsy sampling [77.27% (51/66)] and the sensitivity of single biopsy sampling [68.18% (45/66)] were significantly higher than that of single brush cytology [43.94% (29/66), χ 2=13.99, P<0.001; χ 2=6.92, P=0.009]. Conclusion:Combining brush cytology and biopsy forceps during ERCP enhances diagnostic sensitivity in identifying malignant biliary strictures. Biopsy sampling stands out as more sensitive compared with single brush cytology, emphasizing its role in improving diagnostic capabilities.
