原发性硬化性胆管炎患者胆管癌的检测：单中心经验

The Detection of Cholangiocarcinoma in Primary Sclerosing Cholangitis Patients: Single Center Experience.

作者信息

Kuzu Ufuk Barış, Ödemiş Bülent, Suna Nuretdin, Yıldız Hakan, Parlak Erkan, Dişibeyaz Selçuk, Torun Serkan, Akpınar Muhammet Yener, Coşkun Orhan, Turhan Nesrin, Yüksel Mahmut, Kayaçetin Ertuğrul

机构信息

Department of Gastroenterology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey.

Department of Pathology, Turkiye Yuksek Ihtisas Education and Research Hospital, Sıhhiye, Ankara, Turkey.

出版信息

J Gastrointest Cancer. 2016 Mar;47(1):8-14. doi: 10.1007/s12029-015-9777-1.

DOI:10.1007/s12029-015-9777-1

PMID:26537791

Abstract

PURPOSE

Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease. Cholangiocarcinoma (CCA) is one of the feared complications of PSC. In our study, we aim to establish the success of brush cytology and CA 19-9 in putting the diagnosis of CCA.

METHODS

The data of 30 PSC patients was retrospectively screened whom had brush cytology performed due to dominant strictures. The definitive diagnosis was established by histopathological examination or via radiological/clinic follow-up for at least 12 months.

RESULTS

A total of four patients were excluded from the study. Twenty-six patients diagnosed with PSC, six of which were also diagnosed with CCA, were included in the study. The sensitivity and the specificity of the brush cytology in the diagnosis of CCA in PSC patients were 66.7 and 95%, respectively. CA 19-9 had high correlation with bilirubin level. The optimal level of CA 19-9 in the diagnosis of CCA was determined to be 138.5 U/ml. Superiority of Ramage scoring over CA 19-9 in the diagnosis of CCA in PSC patients was not established (sensitivity and specificity were 50%, 94.7% and 83.3%, 85%, respectively).

CONCLUSION

Brush cytology has moderate sensitivity in differentiating strictures in PSC patients. CA 19-9 has high sensitivity but bilirubin level can affect the CA 19-9. Therefore, advanced techniques and parameters are needed for detecting CCA in PSC patients.

摘要

目的

原发性硬化性胆管炎（PSC）是一种慢性胆汁淤积性肝病。胆管癌（CCA）是PSC令人担忧的并发症之一。在我们的研究中，我们旨在确定刷检细胞学和CA 19-9在CCA诊断中的成功率。

方法

回顾性筛选30例因主要狭窄而进行刷检细胞学检查的PSC患者的数据。通过组织病理学检查或至少12个月的放射学/临床随访确定最终诊断。

结果

共有4例患者被排除在研究之外。26例诊断为PSC的患者被纳入研究，其中6例也被诊断为CCA。PSC患者中刷检细胞学诊断CCA的敏感性和特异性分别为66.7%和95%。CA 19-9与胆红素水平高度相关。诊断CCA时CA 19-9的最佳水平确定为138.5 U/ml。在PSC患者CCA诊断中，未证实拉梅奇评分优于CA 19-9（敏感性和特异性分别为50%、94.7%和83.3%、85%）。