Naito Y, Kawahara A, Okabe Y, Ishida Y, Sadashima E, Murata K, Takase Y, Abe H, Yamaguchi T, Tanigawa M, Mihara Y, Kondo R, Kusano H, Nakayama M, Shimamatsu K, Yano H, Akiba J
Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan.
Department of Pathology, Kurume University School of Medicine, Kurume, Japan.
Cytopathology. 2018 Aug;29(4):349-354. doi: 10.1111/cyt.12565. Epub 2018 Jun 12.
The current study aimed to compare cytology using SurePath (SP)-LBC and biliary tissue histology (BTH) for the diagnosis of biliary disease.
Between January 2014 and December 2016, 57 patients underwent endoscopic retrograde cholangiopancreatography for the diagnosis of biliary disease. Biliary cytological samples were processed using SP-LBC and subsequently BTH was performed. A final diagnosis was confirmed by surgery (23 malignant cases) and clinical follow-up (34 benign and malignant cases): 18 extrahepatic cholangiocarcinoma; 17 intrahepatic/hilar cholangiocarcinoma (intra/H-CC); eight other malignant disease; and 14 benign biliary disease. The diagnoses made using SP-LBC and BTH were classified into four categories: (1) benign; (2) indeterminate; (3) suspicious for malignancy/malignant; and (4) inadequate. In addition, diagnostic accuracy was compared between SP-LBC and BTH.
Although 23% (13/57) of BTH samples were classified as inadequate, all SP-LBC cases were classified as adequate. Among 43 malignant cases, 11 normal, four indeterminate and 28 suspicious for malignancy/malignant were found using SP-LBC (26%, 9% and 65%, respectively), in contrast to 10 inadequate, nine normal, 10 indeterminate and 14 suspicious for malignancy/malignant observed using BTH (23%, 21%, 23%, and 33%, respectively). The identification of malignant cells was strikingly different between SP-LBC and BTH. Furthermore, limited to intra/H-CC, accuracy was significantly higher using SP-LBC than using BTH (P < .001).
SP-LBC of the biliary tract is a useful and reliable method for diagnosing biliary malignant disease and has an advantage over BTH for detecting malignant cells and accurately diagnosing intra/H-CC.
本研究旨在比较使用SurePath（SP）液基薄层制片技术进行的细胞学检查与胆管组织病理学检查（BTH）在诊断胆管疾病方面的差异。
2014年1月至2016年12月期间，57例患者接受了内镜逆行胰胆管造影术以诊断胆管疾病。胆管细胞样本采用SP液基薄层制片技术处理，随后进行胆管组织病理学检查。最终诊断通过手术（23例恶性病例）和临床随访（34例良性和恶性病例）得以确认：18例肝外胆管癌；17例肝内/肝门胆管癌（肝内/肝门-CC）；8例其他恶性疾病；以及14例良性胆管疾病。使用SP液基薄层制片技术和胆管组织病理学检查做出的诊断分为四类：（1）良性；（2）不确定；（3）可疑恶性/恶性；（4）不充分。此外，还比较了SP液基薄层制片技术和胆管组织病理学检查之间的诊断准确性。
尽管23%（13/57）的胆管组织病理学检查样本被归类为不充分，但所有SP液基薄层制片技术病例均被归类为充分。在43例恶性病例中，使用SP液基薄层制片技术发现11例正常、4例不确定和28例可疑恶性/恶性（分别占26%、9%和65%），相比之下，使用胆管组织病理学检查观察到10例不充分、9例正常、10例不确定和14例可疑恶性/恶性（分别占23%、21%、23%和33%）。SP液基薄层制片技术和胆管组织病理学检查在恶性细胞识别方面存在显著差异。此外，仅限于肝内/肝门-CC，SP液基薄层制片技术的准确性显著高于胆管组织病理学检查（P <.001）。
胆管的SP液基薄层制片技术是诊断胆管恶性疾病的一种有用且可靠的方法，在检测恶性细胞和准确诊断肝内/肝门-CC方面比胆管组织病理学检查具有优势。
