Bile cytology: A new scoring system for improving diagnostic accuracy

Abstract

Background Benign and malignant cells need to be distinguished in any cytological examination of bile. Here, we report an original scoring system to improve the diagnostic accuracy of bile cytology. Methods The study used 158 bile aspiration samples obtained for cytological examination. Fourteen cytological findings were used to differentiate benign and malignant samples. Statistical significance tests and multivariate analysis were used to determine and quantify significant findings and develop a scoring system. Results Four cytological findings were significant in discriminating between benign and malignant cells: abnormal chromatin, irregularly arranged nuclei, irregularly overlapped nuclei, and irregular cluster margins. Our newly developed scoring system based on these four cytological findings yielded excellent results with a sensitivity of 87%, specificity of 98%, and an odds ratio of 329. Conclusions The use of our new scoring system is expected to contribute to the diagnostic accuracy of cytological evaluations of bile samples.

Sensitivity of endoscopic ultrasound‐guided fine‐needle aspiration cytology and biopsy for a diagnosis of pancreatic ductal adenocarcinoma: A comparative analysis

“…In addition, if a sample contained even a tiny blood clot, the clot was crushed between two slides with just enough pressure to generate a thin film and then fixed immediately in 95% ethanol and subjected to Papanicolaou staining. We evaluated the cytology preparations in a blinded manner, with evaluation based on established guidelines 12–14 . All cytology slides were independently examined by two cytotechnologists, each with over 10 years of experience, who then diagnosed the lesions.…”

“…We evaluated the cytology preparations in a blinded manner, with evaluation based on established guidelines. [12][13][14] All cytology slides were independently examined by two cytotechnologists, each with over 10 years of experience, who then diagnosed the lesions. Discrepancies were resolved by consensus.…”

Role of Endoscopy in Primary Sclerosing Cholangitis

“…However, the sensitivity for brush cytology alone is probably below 50%, 15 although better results have been reported recently. 16 Novel ways to score cytological findings have been proposed that may increase sensitivity, 17 but negative results mandate close monitoring and/or repeat sampling. However, the specificity of brush cytology is high and the finding of dysplastic cells has important prognostic significance.…”

Bile cytology diagnosis in challenging cases: Validation of diagnostic bile cytology criteria and extensive study for immunocytochemical markers

“…To improve diagnostic accuracy in patients with biliary stricture, bile cytology specimens are obtained via various techniques, such as aspiration, brushing, endoscopic nasobiliary drainage, and forceps biopsy 2 . Despite several studies having attempted to establish standardized criteria, the cytological diagnosis is believed to be among the most challenging aspects of cytology 3–7 . A study group for bile cytology from the Japanese Society of Clinical Cytology (JSCC) has produced perhaps the most reliable “diagnostic bile cytology criteria” (we herein refer to the criteria as the “JSCC criteria”), which are widely used in Japanese medical institutions 5,6 .…”