Comparison of the diagnostic accuracy of peroral video-cholangioscopic visual findings and cholangioscopy-guided forceps biopsy findings for indeterminate biliary lesions: a prospective study

Nishikawa, Takao; Tsuyuguchi, Toshio; Sakai, Yuji; Sugiyama, Harutoshi; Miyazaki, Masaru; Yokosuka, Osamu

doi:10.1016/j.gie.2012.10.011

Cited by 89 publications

(86 citation statements)

References 23 publications

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“…McGuire et al [33], in 1996, first reported a higher yield of positive results obtained through the use of brush cytology in strictures of the body and head of the pancreas, compared with malignant strictures from cancers located at the pancreas genu, tail, and biliary ampulla. In a recent report from Japan, Nishikawa et al [6] compared 3 different sampling methods for the diagnosis of bile duct cancer and found that the accuracy of brushing cytology was significantly higher for nonflat (periductal infiltrating) lesions. Mahmoudi et al [1] reviewed 189 patients and reported that the variables associated with positive cytology brushing included mass size > 1 cm, length of stricture > 1 cm, and age.…”

Section: Discussionmentioning

confidence: 99%

“…Over the past 10 years, the development of a single-operator peroral cholangioscope in which a dedicated mini-forceps biopsy can be used to obtain target cholangioscopy biopsy specimens has increased the diagnostic accuracy of indeterminate biliary lesions [3-6]. A recent systematic review of 10 studies involving 456 patients reported a pooled sensitivity and specificity of cholangioscopy-guided biopsies in the diagnosis of malignant biliary strictures of 60.1 and 98.0%, respectively [4].…”

Section: Discussionmentioning

confidence: 99%

“…In the subgroup analysis of patients with CCA, the pooled sensitivity and specificity to detect CCA were 66.2 and 97.0%, respectively. However, in a provocative paper, Nishikawa et al [6] compared the diagnostic accuracy of peroral cholangioscopy visual findings and cholangioscopy-guided biopsies for indeterminate strictures. They reported a sensitivity, specificity, and accuracy of 100, 91.7, and 97.0%, respectively, for peroral video-cholangioscopic visual findings and of 38.1, 100, and 60.6%, respectively, for cholangioscopy-guided forceps biopsy findings.…”

Section: Discussionmentioning

confidence: 99%

“…Obtaining a tissue diagnosis appears to be a key factor. In recent years, several techniques have emerged for obtaining an adequate cellular specimen from the stricture, such as forceps biopsy during cholangioscopy [3-6] or endoscopic ultrasonography-guided fine needle aspiration/biopsy [7-9]. However, the most commonly used strategy to obtain a tissue sample of the stricture is brush cytology during endoscopic retrograde cholangiopancreatography (ERCP).…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Different Methods for Analysis of Biliary Brush Cytology and of Factors Associated with Positive Diagnosis in an Age-Dependent Retrospective Review

Costa

Canena

Mascarenhas-Lemos

et al. 2018

GE Port J Gastroenterol

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Background and Aims: Brush cytology during endoscopic retrograde cholangiopancreatography (ERCP) is the most frequently used strategy for obtaining a tissue sample from an indeterminate biliary stricture. A recent study reported that age is a factor associated with positive yields, but further analysis of how age influences the results was lacking. We aimed to evaluate clinical effectiveness of biliary cytology and prognostic factors for a positive outcome, especially age. Methods: This study was a single-center, retrospective, clinical study of 77 consecutive patients who underwent brush cytology during ERCP to obtain a diagnosis of an indeterminate biliary stricture. We compared 2 routine cytology techniques: A (smear); B (centrifugation of the cytological material collected and the cut-off brush + cell block when sufficient amount of material was available). The data were collected aiming to compare the accuracy of the different techniques used and the prognostic factors affecting the outcome, with a particular focus on age. The yield for brush cytology was compared with the gold standard defined as either definitive histology or the long-term clinical course. Results: The overall accuracy of the 2 used methods was 75.3%. Sensitivity was 52.5%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 66.1%. Although not statistically significant, there was a trend toward accuracy for method B compared with method A (80.4 vs. 65.4%; p = 0.153). Multiple logistic regression analysis showed that younger age was the only independent prognostic factor associated with a positive diagnosis (OR 0.95; 95% CI 0.90–0.99; p = 0.039). Receiver operating characteristic curves for age yielded an area under the curve value of 68.2%. On the basis of the Youden index, 69 years was found to be the optimal cutoff for age. Conclusions: In this series, the accuracy of routine biliary brush cytology was not equal for all methods and ages; in particular, younger patients (below 69 years) tended to have a higher probability of a correct diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes of Different Methods for Analysis of Biliary Brush Cytology and of Factors Associated with Positive Diagnosis in an Age-Dependent Retrospective Review

Costa

Canena

Mascarenhas-Lemos

et al. 2018

GE Port J Gastroenterol

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“…После проведения хо-лангиоскопии рекомендуется назначение антибио-тиков, в ряде случаев необходимо дренирование желчных путей для профилактики холангита. Не-смотря на это, возможность прицельной биопсии значительно повышает ценность холангиоскопии перед «слепой» биопсией под рентгенологическим контролем [13].…”

Section: рис 3 гистологический материал полученный при биопсии посunclassified

Diagnostics of the tumour of the proximal extrahepatic bile ducts at the early stage of its development with the use of per-oral cholangioscopy

Costamagna¹,

Gvozdev²,

Burdyukov³

et al. 2015

Dok. gastroenterol.

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Холангиокарцинома встречается в 3% случаев от общей заболеваемости раком пищеварительной си-стемы, и чаще всего локализуется в проксимальной части внепеченочных желчных протоков. Пациенты с холангиокарциномой обычно выявляются на поздней стадии, когда возможности специального противоопухолевого лечения уже исчерпаны. Для постановки этого диагноза необходимы, во-первых, мультидисциплинарный подход с участием хирур-гов-онкологов, специалистов лучевой диагностики и врачей-эндоскопистов, а во-вторых, применение современных методов исследования (трансабдоми-нальное ультразвуковое исследование, компьютер-ная и магнитно-резонансная томография с вирту-альной холангиопанкреатографией, эндоскопиче-ская ретроградная холангиопанкреатография). Хо-лангиоскопия является многообещающей методи-кой для выявления холангиокарциномы на ранней стадии заболевания.Мы хотели бы представить клинический случай больного с подозрением на раннюю стадию холан-гиокарциномы. Этот случай был продемонстри-рован в ходе 15-й международной конференции «YES 2015 -Высокие технологии в эндоско -пии пищеварительной системы», проходившей 6-7 июля 2015 г. в Ярославле. Холангиокарцинома остается сложным для диагностики заболеванием с плохим прогнозом. Пациенты с этой патологией обычно выявляются на поздней стадии, когда возможности специального лечения уже исчерпаны. Механическая желтуха чаще всего является первым проявлением заболевания. В случае, когда стандартные методы диагностики, включающие трансабдоминальное ультразвуковое исследование, компьютерную томографию, магнитно-резонансную томографию и эндоскопическую ретроградную холангиопанкреатографию, не дают полного ответа на поставленные клиницистами вопросы, холангиоскопия является многообещающей методикой для выявления холангиокарциномы на ранней стадии заболевания. Ключевые слова: холангиокарцинома, механическая желтуха, эндоскопическая ретроградная холангиопанкреатография, холангиоскопия, внепеченочный желчный проток.Cholangiocarcinoma is a disease having the unfavourable prognosis and difficult to diagnose. This pathology is usually detected at the late stages of its evolution when the possibilities for its specialized treatment are virtually exhausted. In most cases, obstructive jaundice is the earliest manifestation of the disease. The standard diagnostic methods including transabdominal ultrasound study, computed tomography, magnetic resonance imaging, and endoscopic retrograde cholangiopancreatography not infrequently fail to provide all necessary clinical information. It is concluded that cholangioscopy provides a promising tool for the diagnostics of cholangiocarcinoma at the early stages of the disease.

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NBI and High‐Resolution Endoscopy in the Bile Duct and Pancreas

Itoi¹

2017

Comprehensive Atlas of High‐Resolution Endoscopy and Narrowband Imaging

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Comparison of the diagnostic accuracy of peroral video-cholangioscopic visual findings and cholangioscopy-guided forceps biopsy findings for indeterminate biliary lesions: a prospective study

Cited by 89 publications

References 23 publications

Outcomes of Different Methods for Analysis of Biliary Brush Cytology and of Factors Associated with Positive Diagnosis in an Age-Dependent Retrospective Review

Outcomes of Different Methods for Analysis of Biliary Brush Cytology and of Factors Associated with Positive Diagnosis in an Age-Dependent Retrospective Review

Diagnostics of the tumour of the proximal extrahepatic bile ducts at the early stage of its development with the use of per-oral cholangioscopy

NBI and High‐Resolution Endoscopy in the Bile Duct and Pancreas

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