A novel method of forceps biopsy improves the diagnosis of proximal biliary malignancies
Background and Aims: Tissue specimen collection represents a cornerstone in diagnosis of proximal biliary tract malignancies offering great specificity, but only limited sensitivity. To improve the tumor detection rate, we developed a new method of forceps biopsy and compared it prospectively with e...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
08 January 2011
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| In: |
Digestive diseases and sciences
Year: 2011, Volume: 56, Issue: 2, Pages: 596-601 |
| ISSN: | 1573-2568 |
| DOI: | 10.1007/s10620-010-1535-4 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1007/s10620-010-1535-4
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| Author Notes: | Hasan Kulaksiz, Pavel Strnad, Achim Römpp, Guido von Figura, Thomas Barth, Irene Esposito, Peter Schirmacher, Doris Henne-Bruns, Guido Adler, Adolf Stiehl |
| Summary: | Background and Aims: Tissue specimen collection represents a cornerstone in diagnosis of proximal biliary tract malignancies offering great specificity, but only limited sensitivity. To improve the tumor detection rate, we developed a new method of forceps biopsy and compared it prospectively with endoscopic transpapillary brush cytology. Patients and Methods: 43 patients with proximal biliary stenoses, which were suspect for malignancy, undergoing endoscopic retrograde cholangiography were prospectively recruited and subjected to both biopsy [using a double-balloon enteroscopy (DBE) forceps under a guidance of a pusher and guiding catheter with guidewire] and transpapillary brush cytology. The cytological/histological findings were compared with the final clinical diagnosis. Results: 35 out of 43 patients had a malignant disease (33 cholangiocarcinomas, 1 hepatocellular carcinoma, 1 gallbladder carcinoma). The sensitivity of cytology and biopsy in these patients was 49 and 69%, respectively. The method with DBE forceps allowed a pinpoint biopsy of the biliary stenoses. Both methods had 100% specificity, and, when combined, 80% of malignant processes were detected. All patients with non-malignant conditions were correctly assigned by both methods. No clinically relevant complications were observed. Conclusions: The combination of forceps biopsy and transpapillary brush cytology is safe and offers superior detection rates compared to both methods alone, and therefore represents a promising approach in evaluation of proximal biliary tract processes. |
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| Item Description: | Gesehen am 11.07.2022 |
| Physical Description: | Online Resource |
| ISSN: | 1573-2568 |
| DOI: | 10.1007/s10620-010-1535-4 |