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How many cytological examinations should be performed for the diagnosis of malignant biliary stricture via an endoscopic nasobiliary drainage tube?
Author(s) -
Uchida Naohito,
Kamada Hideki,
Ono Masahiro,
Aritomo Yuichi,
Masaki Tsutomu,
Nakatsu Toshiaki,
Kuriyama Shigeki
Publication year - 2008
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2007.05214.x
Subject(s) - medicine , cytology , bile duct , sampling (signal processing) , bile duct carcinoma , gallbladder , carcinoma , major duodenal papilla , radiology , gastroenterology , pathology , filter (signal processing) , computer science , computer vision
Background and Aim: The sensitivity of bile cytology is recognized as being low. Repeating cytological sampling is likely to improve the sensitivity. The aim of this study is to determine the optimal number of repeated cytological sampling of bile obtained via an endoscopic nasobiliary drainage (ENBD) tube for the diagnosis of malignant biliary stricture. Methods: Ninety‐eight patients with malignant biliary stricture who underwent ENBD were enrolled. Diagnoses included bile duct carcinoma ( n = 53), pancreatic carcinoma ( n = 28), carcinoma of the major papilla ( n = 8), gallbladder carcinoma ( n = 6), and hepatocellular carcinoma ( n = 3). Bile was aspirated via an ENBD tube once a day and immediately evaluated cytologically. Results: The median number of cytological samplings via an ENBD tube was 2.8 times (range, 1–10). In 40 of 98 patients with malignant biliary stricture, cytology was positive at the first cytological sampling (sensitivity 40.8%). Cytology was cumulatively positive in 71 of 98 patients (sensitivity 72.4%) from which repeated samples were taken. In 71 patients with positive cytology, correlation of the positive rate and the number of cytological samplings performed was investigated. In 68 of 71 (95.8%) patients with positive cytology, positive results were obtained by or at the sixth examination. Conclusions: Bile cytology via an ENBD tube is an easy method, and has been shown to have relatively high sensitivity. The optimal number of repeated cytological samplings using bile obtained via an ENBD tube for the diagnosis of malignant biliary stricture was concluded to be six.