Combined brush cytology and stent placement in a single session for presumed malignant biliary stricture

Kawada, Natsuko; Uehara, Hiroyuki; Katayama, Kazuhiro; Takano, Yasuna; Takakura, Rena; Imanaka, Kazuho; Ohkawa, Kazuyoshi; Takenaka, Akemi; Ishikawa, Osamu

doi:10.1111/j.1440-1746.2011.06725.x

Cited by 11 publications

(7 citation statements)

References 19 publications

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“…In our study, stricture location was found to have no effect on the diagnostic success of brush cytology. Similar results were reported [ 5 , 31 ], although there are some studies that reportthe opposite [ 33 , 34 ]. As reported that the type of tumor affects the success of brush cytology [ 6 , 7 , 33 ], Kurzawinski et al [ 7 ] demonstrated that the sensitivity of brush cytology is the highest for periampullar tumors, moderate for CCA, and the lowest for pancreas cancers.…”

Section: Discussionsupporting

confidence: 87%

“…Previously published paper reported lower sensitivity of brush cytology in detecting pancreatobiliary malignancies than our study (35–48%) [ 23 – 28 ]. However, some studies reported higher diagnostic sensitivity of brush cytology (57–83%) [ 19 , 29 – 31 ]. The reason for these differences in sensitivity has not been well understood.…”

Section: Discussionmentioning

confidence: 99%

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The Diagnostic Value of Brush Cytology Alone and in Combination with Tumor Markers in Pancreaticobiliary Strictures

Kuzu

Ödemiş

Turhan

et al. 2015

Gastroenterology Research and Practice

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Aim. Differentiation of malignant and benign strictures constitutes a problem despite the increasing experience of the endoscopists, radiologists, and pathologists. The aim of our study is to determine the factors that affect the efficacy of the ERCP guided brush cytology in PBS and to evaluate its diagnostic success when used alone and together with tumor markers. Method. The data from brush cytologies of 301 PBS patients were collected retrospectively and analyzed. The final diagnosis was approved based on the histological examination of the tissue taken surgically or by other methods. In the absence of a histological diagnosis, the final diagnosis was based on radiological studies or the results of a 12-month clinical follow up. Results. A total of 28 patients were excluded from the study. From the remaining 273 patients 299 samples were analyzed. The sensitivity and the specificity of brush cytology in diagnosing malignancy are 62.4% and 97.7, respectively. The sensitivity of brush cytology increased to 94.1% when combined with CA-19.9 and CA-125. Conclusion. Brush cytology is a useful method in diagnosing pancreaticobiliary strictures. Advanced age, stricture dilatation before sampling, the presence of a mass identified by radiological studies, high levels of CA-19.9, ALT, and total bilirubin increase the sensitivity of brush cytology.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

The Diagnostic Value of Brush Cytology Alone and in Combination with Tumor Markers in Pancreaticobiliary Strictures

Kuzu

Ödemiş

Turhan

et al. 2015

Gastroenterology Research and Practice

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“…The aim of our current study was to investigate the inhibition of tumor growth; however, our study lasted only for 16 days. As it is known, the significant role of silicone-coated 125 I seeds are to be applied in the clinical work, treatment of patients, where the silicone 125 I seeds are combined with a stent as a treatment for extrahepatic CC, may require much more time in vivo[ 24 – 25 ]. Therefore, a longer observation period is require, so far, we have successfully complete this novel silicone 125 I seeds in combination with the placement of a stent in pig bile duct.…”

Section: Discussionmentioning

confidence: 99%

Novel Silicone-Coated 125I Seeds for the Treatment of Extrahepatic Cholangiocarcinoma

Guo

Zhang

et al. 2016

PLoS ONE

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125I seeds coated with titanium are considered a safe and effective interstitial brachytherapy for tumors, while the cost of 125I seeds is a major problem for the patients implanting lots of seeds. The aim of this paper was to develop a novel silicone coating for 125I seeds with a lower cost. In order to show the radionuclide utilization ratio, the silicone was coated onto the seeds using the electro-spinning method and the radioactivity was evaluated, then the anti-tumor efficacy of silicone 125I seeds was compared with titanium 125I seeds. The seeds were divided into four groups: A (control), B (pure silicone), C (silicone 125I), D (titanium 125I) at 2 Gy or 4 Gy. Their anti-tumour activity and mechanism were assessed in vitro and in vivo using a human extrahepatic cholangiocarcinoma cell line FRH-0201 and tumor-bearing BALB/c nude mice. The silicone 125I seeds showed higher radioactivity; the rate of cell apoptosis in vitro and the histopathology in vivo demonstrated that the silicone 125I seeds shared similar anti-tumor efficacy with the titanium 125I seeds for the treatment of extrahepatic cholangiocarcinoma, while they have a much lower cost.

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“…Biliary strictures are byproducts of benign and malignant diseases involving the biliary tree, pancreas, gallbladder, or ampulla [1-4]. Accurate pathological diagnosis of biliary strictures remains clinically challenging, but is essential for choosing the correct treatment [4,5].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Malignant Biliary Strictures in Patients with Atypical or Suspicious Cells on Brush Cytology

Park

Jeon

2019

Clin Endosc

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Background/Aims Pathological diagnosis of biliary strictures with atypical or suspicious cells on endoscopic retrograde brush cytology and indeterminate strictures on imaging is challenging. The aim of this study was to identify markers for malignant strictures in such cases. Methods We retrospectively analyzed data collected from 146 consecutive patients with indeterminate biliary strictures on imaging who underwent endoscopic retrograde brush cytology from 2007 to 2013. Factors associated with malignant strictures in patients with atypical or suspicious cells on brush cytology were identified. Results Among the 67 patients with a malignant disease (48 cholangiocarcinoma, 6 gallbladder cancer, 5 pancreatic cancer, 5 ampulla of Vater cancer, and 3 other types), 36 (53.7%) had atypical or suspicious cells on brush cytology. Among these, the factors that independently correlated with malignant strictures were stricture length (odds ratio [OR], 5.259; 95% confidence interval [CI], 1.802– 15.294) and elevated carbohydrate antigen 19-9 (CA19-9) (OR, 3.492; 95% CI, 1.242–9.815), carcinoembryonic antigen (CEA) (OR, 4.909; 95% CI, 1.694–14.224), alkaline phosphatase (ALP) (OR, 3.362; 95% CI, 1.207–9.361), and gamma-glutamyl transpeptidase (rGT) (OR, 4.318; 95% CI, 1.512–12.262). Conclusions Elevated levels of CA19-9, CEA, ALP, and rGT and stricture length are associated with malignant strictures in patients with indeterminate biliary strictures on imaging and atypical or suspicious cells on brush cytology.

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Combined brush cytology and stent placement in a single session for presumed malignant biliary stricture

Cited by 11 publications

References 19 publications

The Diagnostic Value of Brush Cytology Alone and in Combination with Tumor Markers in Pancreaticobiliary Strictures

The Diagnostic Value of Brush Cytology Alone and in Combination with Tumor Markers in Pancreaticobiliary Strictures

Novel Silicone-Coated 125I Seeds for the Treatment of Extrahepatic Cholangiocarcinoma

Factors Associated with Malignant Biliary Strictures in Patients with Atypical or Suspicious Cells on Brush Cytology

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