Clinical Usefulness of Bile Cytology Obtained from Biliary Drainage Tube for Diagnosing Cholangiocarcinoma.
10.4166/kjg.2014.63.2.107
- Author:
Jin Yong KIM
1
;
Joon Hyuk CHOI
;
Jin Hee KIM
;
Chang Lae KIM
;
Seung Hyeon BAE
;
Young Kwon CHOI
;
Yeonjung HA
;
Min Joo SONG
;
Jun Ho CHOI
;
Seung Mo HONG
;
Myung Hwan KIM
Author Information
1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. cladius2@naver.com
- Publication Type:Original Article ; English Abstract
- Keywords:
Bile cytology;
Cholangiocarcinoma;
Endoscopic nasobiliary drainage;
Percutaneous transhepatic biliary drainage
- MeSH:
Aged;
Bile/*cytology;
Bile Duct Neoplasms/*diagnosis/pathology/radiography;
CA-19-9 Antigen/metabolism;
Cholangiocarcinoma/*diagnosis/pathology/radiography;
Drainage;
Female;
Humans;
Male;
Middle Aged;
Multivariate Analysis;
Neoplasm Staging;
Retrospective Studies
- From:The Korean Journal of Gastroenterology
2014;63(2):107-113
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Biliary drainage is performed in many patients with cholangiocarcinoma (CCA) to relieve obstructive jaundice. For those who have undergone biliary drainage, bile cytology can be easily performed since the access is already achieved. This study aims to determine the clinical usefulness of bile cytology for the diagnosis of CCA and to evaluate factors affecting its diagnostic yield. METHODS: A total of 766 consecutive patients with CCA underwent bile cytology via endoscopic nasobiliary drainage or percutaneous transhepatic biliary drainage from January 2000 to June 2012. Data were collected by retrospectively reviewing the medical records. We evaluated the diagnostic yield of bile cytology with/without other sampling methods including brush cytology and endobiliary forcep biopsy, and the optimal number of repeated bile sampling. Several factors affecting diagnostic yield were then analyzed. RESULTS: The sensitivity of bile cytology, endobiliary forceps biopsy, and a combination of both sampling methods were 24.7% (189/766), 74.4% (259/348), and 77.9% (271/348), respectively. The cumulative positive rate of bile sampling increased from 40.7% (77/189) at first sampling to 93.1% (176/189) at third sampling. On multivariate analysis, factors associated with positive bile cytology were perihilar tumor location, intraductal growing tumor type, tumor extent > or =20 mm, poorly differentiated grade tumor, and three or more samplings. CONCLUSIONS: Although bile cytology itself has a low sensitivity in diagnosing CCA, it has an additive role when combined with endobiliary forceps biopsy. Due to the relative ease and low cost, bile cytology can be considered a reasonable complementary diagnostic tool for diagnosing CCA.
