Endoscopic brush cytology for diagnosis of malignant biliary stricture
10.3760/cma.j.issn.1007-5232.2011.01.003
- VernacularTitle:经内镜细胞刷检查对胆管恶性狭窄性病变的诊断价值
- Author:
Xiaofeng ZHANG
;
Xia WANG
;
Xiao ZHANG
;
Nan JIANG
;
Jianfeng YANG
;
Yuhua YU
;
Qiaoyun LI
;
Rujun XU
- Publication Type:Journal Article
- Keywords:
Biliary duct neoplasns;
Brushing cytology;
Cholangiopancreatography,endoscopic retrograde
- From:
Chinese Journal of Digestive Endoscopy
2011;28(1):9-12
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate brush cytology under endoscopic retrograde cholangiopancreatography (ERCP) for malignant biliary strictures, and to analyze the factors influencing the diagnosis yield.Methods Brush cytology was applied in 144 patients with suspected malignant biliary strictures at ERCP.Brushing in bile duct was performed for 10 times from 2004 to 2006, while at least 20 times of brushing and repeated manipulation were performed at biliary strictures from 2007 to 2009. Cytological samples were processed immediately after brushing and analyzed by the same pathologist. Efficacy of brush diagnosis was evaluated based on reference to histopathology after surgery and/or clinical diagnostic criteria. Results Malignant stricture was finally diagnosed in 96 patients, and benign diseases in other 48. Brush cytology was positive in 78 of 96 patients with malignant stricture ( sensitivity 81.3% ), and negative in all patients without malignancy ( specificity 100. 0% ). Overall accuracy of diagnosis was 87.5%. Positive rate of malignancy by brush between 2007 and 2009 was 87.7% (50/57), while that between 2004 and 2006 was 71.8%, which were significantly different ( P ＜ 0. 05 ). The positive rate was not correlated with stricture location or tumor type. No major complications occurred, except for 4 moderate acute pancreatitis, 3 cholangiolitis and 2 biliary bleeding. Conclusion Brush cytology is of high sensitivity and specificity for malignant biliary stricture.Repeated brushing and manipulation can facilitate diagnosis yield.
