Biliary brush cytology: Factors associated with positive yields on biliary brush cytology

Mahmoudi, Nasim; Enns, Robert; Amar, Jack; Al-Ali, Jaber; Lam, Eric; Telford, Jennifer J.

doi:10.3748/wjg.14.569

Cited by 50 publications

(87 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Finally, obtaining a tissue diagnosis is extremely difficult. Bile duct brushings (in the event of a biliary stricture) only have a yield of 23% to 41% (3,4). The diagnostic rate of EUS (endoscopic ultrasound)-guided biopsies for pancreatic masses is only about 71% (5).…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Identifying Pancreatic Cancer Based on Serum Metabolomics

Bathe

Shaykhutdinov

Kopciuk

et al. 2011

Cancer Epidemiology, Biomarkers &Amp; Prevention

150

125

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Feasibility of Identifying Pancreatic Cancer Based on Serum Metabolomics

Bathe

Shaykhutdinov

Kopciuk

et al. 2011

Cancer Epidemiology, Biomarkers &Amp; Prevention

150

125

View full text Add to dashboard Cite

show abstract

“…however, their use for differentiating between cancer and benign diseases is limited due to insufficient sensitivity and benign results are often considered to be unreliable (27)(28)(29)(30). Therefore, novel diagnostic methods are required and of high importance.…”

Section: Discussionmentioning

confidence: 99%

Identification of bile biomarkers of biliary tract cancer through a liquid chromatography/mass spectrometry-based metabolomic method

Cheng

Ding

et al. 2014

Molecular Medicine Reports

View full text Add to dashboard Cite

Abstract. The incidence and mortality rate of biliary tract cancer have been increasing worldwide; however, its diagnosis and prognosis have not improved in recent years. A novel approach, termed 'metabolomics', may have the potential to be developed as an effective diagnostic tool. The present study prospectively obtained bile samples from 115 individuals, including 32 patients with biliary tract cancer, 61 patients with benign biliary tract diseases and 22 normal controls. A liquid chromatography/mass spectrometry (LC/MS)-based approach was used to investigate the differences in bile samples between the three groups, followed by multivariate statistical analysis, which included partial least squares projection to latent structures with discriminant analysis (PLS-DA) and orthogonal projection to latent structures with discriminant analysis (OPLS-DA). The metabolomic 2D score plot and 3D plot revealed clear separation between the cancer, benign and normal control groups by PLS-DA. To further address the significant difficulties in clinically differentiating between biliary tract cancer and benign biliary tract diseases, OPLS-DA was performed to distinguish between the two disease groups and to select potential biomarkers. The cancer and benign groups were well differentiated. The metabolic analysis revealed significantly lower levels of lysophosphatidylcholine, phenylalanine, 2-octenoylcarnitine, tryptophan and significantly higher levels of taurine-and glycine-conjugated bile acids in the bile from patients with biliary tract cancer compared with those in the bile from patients with benign biliary tract disease. The present study suggested that an LC/MS-based metabolomic investigation provides a potent and promising approach for discriminating biliary tract cancer from benign biliary tract diseases and the identified specific metabolites may offer potential as novel biomarkers for the early detection of biliary tract cancer.

show abstract

“…Witt et al [22 ]reported that the risk of malignancy was significantly higher in older patients, those with a stricture within the distal CBD, those where the endoscopic/fluoroscopic appearance was suspicious for malignancy, those with a pancreatic-head mass and those with a CA 19.9 level of >300. Mahmoudi et al [1 ]found that a positive yield was associated with older age, a mass size >1 cm and a stricture length of >1 cm. We found that the diagnostic yield was high for proximal CBD strictures (p = 0.02).…”

Section: Discussionmentioning

confidence: 99%

“…The diagnostic specificity of this technique is very high and ranges from 90 to 100% [1,2]. However, the reported diagnostic yield and sensitivity remain low and are highly variable, ranging from 30 to 80% [9,10].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Biliary Brush Cytology Revisited

Mehmood

Loya²,

Yusuf³

2016

Acta Cytologica

View full text Add to dashboard Cite

Purpose: To evaluate the diagnostic yield of biliary brush cytology and the factors affecting positive results in patients with biliary strictures. Patients and Methods: The medical records of all patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with biliary brush cytology at our institution from November 2004 to December 2013 were reviewed in this retrospective study. The yield of positive brush cytology and the factors affecting positive yield, such as stricture location, age, gender and preprocedure CA 19.9 level were assessed. The final histopathology, diagnosis obtained by other methods, such as endoscopic ultrasound-guided fine-needle aspiration cytology, CT scan, Tru-Cut biopsy and/or clinical/radiological follow-up were used to identify true- and false-positive/negative results. The brush cytology results were divided into 4 main categories: malignant, benign, atypical cells and inadequate. Results: A total of 1,168 patients underwent ERCP during this 9-year period. Out of these, 142 patients had ERCP and biliary brushings for diagnosis. The mean age of the patients at presentation was 58.7 years (range 23-84 years; 64.8% males). The indication for referral was obstructive jaundice in all patients. Of the 142 patients, 77 (54.2%) had a distal common bile duct (CBD) stricture and 65 (45.8%) had a proximal /complex hilar stricture. The strictures were classified as proximal or distal, based on their relationship with the cystic duct; those below the cystic duct insertion were classified as distal and those above it were considered proximal. The diagnostic yield of brush cytology was 58.5%. The diagnostic yield was higher for proximal than for distal CBD strictures (67 vs. 50%; p = 0.047). It was also higher for females (58 vs. 57.6%; p = 0.94), patients >50 years (60 vs. 50%; p = 0.29) and those with a CA 19.9 level >300 IU/ml (59.4 vs. 55.5%; p = 0.65) but did not reach statistical significance for any of these parameters. Complete follow-up data were available for 96 patients and 46 patients were lost to follow-up. The sensitivity, specificity, positive predictive value and negative predictive value were 65.3, 100, 100 and 27%, respectively. When patients with atypia were included in the group with positive results, the diagnostic yield increased to 65.5% with a diagnostic sensitivity of 68.6%. There were 27 false-negative diagnoses, 10 patients were true-negative and no patients had a false-positive diagnosis. Conclusion: Biliary brush cytology is a safe and simple initial diagnostic procedure in patients with biliary strictures and can be performed at the time of therapeutic ERCP. If performed correctly and then interpreted by a dedicated cytopathologist, it has a good diagnostic yield and sensitivity. We feel that the low rates of success with this technique reported in some earlier studies have led to a feeling that this is not a particularly useful technique. We recommend that this topic should be revisited, and that the technique should be used more often.

show abstract

Biliary brush cytology: Factors associated with positive yields on biliary brush cytology

Abstract: Our results revealed a 41% positive yield from brushing cytology. The sensitivity of biliary brushing cytology in our center was 61% and the specificity was 98%. Predictors of positive yield include older age, mass size>1 cm, and stricture length of >1 cm.

Cited by 50 publications

References 21 publications

Feasibility of Identifying Pancreatic Cancer Based on Serum Metabolomics

Feasibility of Identifying Pancreatic Cancer Based on Serum Metabolomics

Identification of bile biomarkers of biliary tract cancer through a liquid chromatography/mass spectrometry-based metabolomic method

Biliary Brush Cytology Revisited

Contact Info

Product

Resources

About