Bile aspiration cytology in diagnosis of bile duct carcinoma: factors associated with positive yields

Abstract

In BDC patients with ENBD or PTCD, repeated BAC is useful, and six times was the optimum number of repeat samplings. Although the sensitivity of BAC is not sufficient for the preoperative diagnosis of malignant biliary stricture, the three independent factors noted above predict positive yields and indicate whether or not BAC should be repeated up to six times.

Randomized controlled trial on timing and number of sampling for bile aspiration cytology

“…According to our previous analysis [10], positivity was lower in patients with ENBD than those with PTBD, perhaps because the collection volume was often smaller in the former, leading to a lower cellular yield. The bile cytology positivity per session was low, which was consistent with previous studies on exfoliative bile cytology [1][2][3][4][5][6][7][8][9]. However, this study demonstrated that positivity increased up to approximately 50% with repeat cytology.…”

“…Abdelghani et al. reported that papillary macroscopic tumor type was linked with higher positivity. Tumor cells of the protruding tumor type, compared to the sclerosing tumor type, may be more easily exfoliated, possibly leading to high sensitivity.…”

“…Currently, bile aspiration cytology remains important in the diagnosis of biliary stricture. Although several authors [1][2][3][4][5][6][7][8][9] have reported the results of bile aspiration cytology, these previous studies exhibited specific limitations, including a small number of study patients, retrospective analysis, a disorganized protocol, and/or a heterogeneous population. Recently, we showed that bile sampling by aspiration through a drainage catheter is the most effective method for cytology, compared with sampling by saline flush through a drainage catheter or direct sampling from a drainage bag [10].…”

Prospective randomized controlled study comparing cell block method and conventional smear method for bile cytology

“…Although bile cytology is widely used for pathological confirmation of biliary and pancreatic tumors, its diagnostic efficacy is not satisfactory and may greatly vary depending on the level of proficiency of the cytopathologists or cytoscreeners when only the smear method is used . In contrast, the cell block (CB) method allows cytological and/or histological evaluation with hematoxylin‐eosin (HE) staining and with immunostaining for serial sections if necessary…”

“…A LTHOUGH BILE CYTOLOGY is widely used for pathological confirmation of biliary and pancreatic tumors, its diagnostic efficacy is not satisfactory and may greatly vary depending on the level of proficiency of the cytopathologists or cytoscreeners when only the smear method is used. [1][2][3][4][5][6][7][8][9][10][11][12] In contrast, the cell block (CB) method allows cytological and/or histological evaluation with hematoxylin-eosin (HE) staining and with immunostaining for serial sections if necessary. 13 We have previously reported the usefulness of the CB method using sodium alginate (SA) in patients who had undergone endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) 14 and pancreatic juice cytology.…”