DOI QR코드

DOI QR Code

Diagnosis of Malignant Biliary Strictures: Conventional or Negative Pressure Brush Cytology?

  • Published : 2016.10.01

Abstract

Background/Objective: The aim of this study was to perform a comparative evaluation of the yields of conventional brush cytology and brush cytology with negative pressure in the diagnosis of malignant biliary strictures. Methods: A total of 132 consecutive patients undergoing endoscopic were identified. Of these, 88.0 had brush cytology after ERCP and 44 were Brush cytology with negative pressure. Retrograde cholangiopancreatography (ERCP) including brush cytology and brush cytology with negative pressure in patients with biliary strictures between 2012-2015. Endoscopic retrograde cholangiography was performed with a standard videoduodenoscope Olympus TFJ 160-R (Olympus, Hamburg, Germany) and brush cytology with a Cook medical Double Lumen Biliary BrushTM (Cytology). Means and standard frequencies were used to calculate variables. Results: Positive results for malignancy were obtained in 22 of 88 patients (25%) by brush cytology and 31 of 44 patients (70.4 %) by brush cytology with negative pressure. Conclusions: Sensitivity of cytology sampling could be maximized by negative pressure during ERCP.

Keywords

References

  1. Alizadeh MAH, Mousavi M, Salehi B, et al (2011). Biliary brush cytology in the assessment of biliary strictures at a tertiary center in Iran. Asian Pac J Cancer Prev, 12, 2793-6.
  2. Brugge WR, DeWitt J, Klapman JB, et al (2014). Techniques for cytologic sampling of pancreatic and bile duct lesions: The Papanicolaou Society of Cytopathology Guidelines. CytoJournal, 11, 2-8. https://doi.org/10.4103/1742-6413.126223
  3. Davidson B, Varsamidakis N, Dooley J, et al (1992). Value of exfoliative cytology for investigating bile duct strictures. Gut, 33, 1408-11. https://doi.org/10.1136/gut.33.10.1408
  4. De Peralta-Venturina MN, Wong DK, Purslow MJ, et al (1996). Biliary tract cytology in specimens obtained by direct cholangiographic procedures: a study of 74 cases diagnostic. cytopathology, 14, 334-48. https://doi.org/10.1002/(SICI)1097-0339(199605)14:4<334::AID-DC12>3.0.CO;2-L
  5. Desa L, Akosa A, Lazzara S, et al (1991). Cytodiagnosis in the management of extrahepatic biliary stricture. Gut, 32, 1188-91. https://doi.org/10.1136/gut.32.10.1188
  6. Eiholm S, Thielsen P, Kromann-Andersen H (2013). Endoscopic brush cytology from the biliary duct system is still valuable. group, 1, 2.
  7. Ferrari AP, Lichtenstein DR, Slivka A, et al (1994). Brush cytology during ERCP for the diagnosis of biliary and pancreatic malignancies. Gastrointest Endosc, 40, 140-5. https://doi.org/10.1016/S0016-5107(94)70155-5
  8. Foutch P, Kerr D, Harlan J, et al (1990a). Endoscopic Retrograde Wire--Guided Brush Cytology for Diagnosis of Patients with Malignant Obstruction of the Bile Duct. Am J Gastroenterol, 85, 150-6.
  9. Foutch P, Kerr D, Harlan J, et al (1990b). Endoscopic retrograde wire-guided brush cytology for diagnosis of patients with malignant obstruction of the bile duct. Am J Gastroenterol, 85, 791-5.
  10. Furmanczyk PS, Grieco VS, Agoff SN (2005). Biliary Brush Cytology and the Detection of Cholangiocarcinoma in Primary Sclerosing Cholangitis Evaluation of Specific Cytomorphologic Features and CA19-9 Levels. Am J Clin Pathol, 124, 355-60. https://doi.org/10.1309/J030JYPWKQTHCLNJ
  11. Geraci G, Pisello F, Arnone E, et al (2008). Endoscopic cytology in biliary strictures. Personal experience. G Chir, 29, 403-6.
  12. Kawada N, Uehara H, Katayama K, et al (2011). Combined brush cytology and stent placement in a single session for presumed malignant biliary stricture. J Gastroenterol Hepatol, 26, 1247-51. https://doi.org/10.1111/j.1440-1746.2011.06725.x
  13. Kocjan G, Smith AN (1997). Bile duct brushings cytology: potential pitfalls in diagnosis. Diagn Cytopathol, 16, 358-63. https://doi.org/10.1002/(SICI)1097-0339(199704)16:4<358::AID-DC11>3.0.CO;2-J
  14. Kulaksiz H, Strnad P, Rompp A, et al (2011). A novel method of forceps biopsy improves the diagnosis of proximal biliary malignancies. Dig Dis Sci, 56, 596-601. https://doi.org/10.1007/s10620-010-1535-4
  15. Kurzawinski TR, Deery A, Dooley JS, et al (1993). A prospective study of biliary cytology in 100 patients with bile duct strictures. Hepatology, 18, 1399-403. https://doi.org/10.1002/hep.1840180618
  16. Lee JG, Leung JW, Baillie J, et al (1995). Benign, dysplastic, or malignant--making sense of endoscopic bile duct brush cytology: results in 149 consecutive patients. Am J Gastroenterol, 90, 722-6.
  17. Lopez-Jurado RT, Acosta GC, Pintos MA, et al (2009). Diagnostic yield of brush cytology for biliary stenosis during ERCP. Rev Esp Enferm Dig, 101, 385-94.
  18. Macken E, Drijkoningen M, Van Aken E, et al (1999). Brush cytology of ductal strictures during ERCP. Acta Gastroenterol Belg, 63, 254-9.
  19. Nanda A, Brown JM, Berger SH, et al (2015). Triple modality testing by endoscopic retrograde cholangiopancreatography for the diagnosis of cholangiocarcinoma. Therap Adv Gastroenterol, 8, 56-65. https://doi.org/10.1177/1756283X14564674
  20. Osnes M, Serck-Hanssen A, Myren J (1974). Endoscopic retrograde brush cytology (ERBC) of the biliary and pancreatic ducts. Scand J Gastroenterol Suppl, 10, 829-31.
  21. Salomao M, Gonda TA, Margolskee E, et al (2015). Strategies for improving diagnostic accuracy of biliary strictures. Cancer Cytopathol, 123, 244-52. https://doi.org/10.1002/cncy.21509
  22. Shanbhogue AKP, Tirumani SH, Prasad SR, et al (2011). Benign biliary strictures: a current comprehensive clinical and imaging review. AJR Am J Roentgenol, 197, 295-306. https://doi.org/10.2214/AJR.11.6675
  23. Singh V, Bhasin S, Nain CK, et al (2003). Brush cytology in malignant biliary obstruction. Indian J Pathol Microbiol, 46, 197-200.
  24. Stewart C, Mills P, Carter R, et al (2001). Brush cytology in the assessment of pancreatico-biliary strictures: a review of 406 cases. J Clin Pathol, 54, 449-55. https://doi.org/10.1136/jcp.54.6.449
  25. Sturm PD, Rauws EA, Hruban RH, et al (1999). Clinical Value of K-ras Codon 12 Analysis and Endobiliary Brush Cytology for the Diagnosis of Malignant Extrahepatic BileDuct Stenosis. Clin Cancer Res, 5, 629-35.
  26. Sugimoto S, Matsubayashi H, Kimura H, et al (2014). Diagnosis of bile duct cancer by bile cytology: usefulness of post-brushing biliary lavage fluid. Endosc Int Open, 15, 394-403.
  27. Tapping C, Byass O, Cast J (2012). Cytological sampling versus forceps biopsy during percutaneous transhepatic biliary drainage and analysis of factors predicting success. J Vasc Interv Radiol, 35, 883-9.
  28. Urbano M, Rosa A, Gomes D, et al (2008). Team approach to ERCP-directed single-brush cytology for the diagnosis of malignancy. Rev Esp Enferm Dig, 100, 462-65.