VALUE OF ENDOBILIARY BRUSH CYTOLOGY AND BIOPSIES FOR THE DIAGNOSIS OF MALIGNANT BILE-DUCT STENOSIS - RESULTS OF A PROSPECTIVE-STUDY
VALUE OF ENDOBILIARY BRUSH CYTOLOGY AND BIOPSIES FOR THE DIAGNOSIS OF MALIGNANT BILE-DUCT STENOSIS - RESULTS OF A PROSPECTIVE-STUDY
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DOI：
10.1016/s0016-5107(95)70012-9
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发表时间：
1995-12-01
影响因子：
7.7
通讯作者：
BORY, R
中科院分区：
文献类型：
--
作者：
PONCHON, T;GAGNON, P;BORY, R
背景：在考虑采用非手术方法治疗胆管狭窄之前，组织诊断是非常必要的。在一项前瞻性研究中，我们评估了在内镜逆行cholangiography.Methods：233例连续患者在超声和CT扫描未检测到肿块时进行胆管刷检细胞学检查和胆管狭窄活检的可行性和可靠性。210例（90%）的细胞学材料足以进行分析，128例（55%）进行了活检。115例患者同时进行了细胞学检查和活检（49%）。对于恶性狭窄的诊断，细胞学检查的敏感性为35%，活检为43%，细胞学和活检联合检查的敏感性为63%。对于细胞学和活检，特异性为97%。在癌症的情况下，主要涉及胆管，敏感性为86%时，结合细胞学和活检。结论：胆管内取样技术上是困难的，并具有有限的敏感性诊断恶性胆管狭窄。活检应与细胞学检查相结合，以增加敏感性。
Background: Before considering a nonsurgical method of management of a bile duct stenosis, a tissue diagnosis is highly desirable. In a prospective study we have evaluated the feasibility and reliability of endobiliary brush cytology and biopsies performed at the time of endoscopic retrograde cholangiography.Methods: Two hundred thirty-three consecutive patients underwent an attempt at endobiliary brush cytology and biopsies of bile duct stenosis when no mass was detected on ultrasound and CT scan.Results: The material for cytology was sufficient for analysis in 210 cases (90%) and biopsies were obtained in 128 cases (55%). One hundred fifteen patients had both cytology and biopsies (49%). For the diagnosis of malignant stenosis, the sensitivity was 35% for cytology, 43% for biopsies, and 63% for the combination of cytology and biopsies. For both cytology and biopsies, the specificity was 97%. In the cases of cancer primarily involving the bile ducts, the sensitivity was 86% when combining both cytology and biopsies.Conclusions: Endobiliary sampling is technically difficult and has a limited sensitivity for the diagnosis of malignant biliary stenosis. Biopsies should be combined with cytology to increase the sensitivity.