Siddiqui Momin T, Gokaslan S Tunc, Saboorian M Hossein, Carrick Kelley, Ashfaq Raheela
Department of Pathology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA.
Cancer. 2003 Aug 25;99(4):205-10. doi: 10.1002/cncr.11481.
Bile duct brushing cytology is a common procedure for the exclusion of adenocarcinoma in the bile duct. The authors evaluated the use of ThinPrep (TP) to determine whether the information obtained is equivalent to that found with conventional smear cytology (CS).
Thirty-eight prospectively collected endoscope retrograde cholangiopancreatography-guided bile duct brushing samples were split in the following manner. First, two to four CS were prepared and immediately spray-fixed or wet-fixed. Second, the remaining sample was rinsed in PreservCyt (Cytyc Corp., Boxborough, MA). In the laboratory, one TP slide was prepared from each sample. TP and CS were stained by routine Papanicolaou stain. For the current study, TP and CS were reviewed independently by two cytopathologists. The diagnoses made by the two methods were compared with the final histology.
The cytologic diagnoses for both TP and CS were categorized into five main groups: 1) unsatisfactory, 2) negative, 3) reactive, 4) suspicious for malignancy, and 5) malignant. The diagnoses on the 38 TP bile duct brushings and CS were categorized as follows: 1) unsatisfactory-2, 4; 2) negative-7, 4; 3) reactive-10, 14; 4) suspicious for malignancy-9, 9; and 5) malignant-10, 7, respectively. Histologic follow-up was available in 14 cases (reactive-4, suspicious for malignancy-1, and malignant-9). The sensitivity was 77% for TP and 66% for CS. The specificity was 100% for both methods.
The two methods described in the current study detected equivalent disease on bile duct brushings. TP was found to provide better preservation and cytologic detail. However, the diagnostic criteria may require modification.
胆管刷检细胞学检查是排除胆管腺癌的常用方法。作者评估了液基薄层制片（TP）的应用，以确定所获得的信息是否等同于传统涂片细胞学检查（CS）。
将38例前瞻性收集的经内镜逆行胰胆管造影引导下的胆管刷检样本按以下方式进行分割。首先，制备两到四张传统涂片并立即进行喷雾固定或湿固定。其次，将剩余样本在保存液（Cytyc公司，马萨诸塞州博克斯伯勒）中冲洗。在实验室中，从每个样本制备一张液基薄层制片玻片。液基薄层制片和传统涂片采用常规巴氏染色。对于本研究，两名细胞病理学家分别独立复查液基薄层制片和传统涂片。将两种方法做出的诊断与最终组织学结果进行比较。
液基薄层制片和传统涂片的细胞学诊断分为五个主要类别：1）不满意；2）阴性；3）反应性；4）可疑恶性；5）恶性。38例液基薄层制片胆管刷检和传统涂片的诊断分类如下：1）不满意 - 2例、4例；2）阴性 - 7例、4例；3）反应性 - 10例、14例；4）可疑恶性 - 9例、9例；5）恶性 - 10例、7例。14例有组织学随访结果（反应性 - 4例，可疑恶性 - 1例，恶性 - 9例）。液基薄层制片的敏感性为77%，传统涂片为66%。两种方法的特异性均为100%。
本研究中描述的两种方法在胆管刷检中检测到的疾病情况相当。发现液基薄层制片能提供更好的保存效果和细胞学细节。然而，诊断标准可能需要修改。
