Jung Eun Suk, Park Se Woo, Kim Jung Hee, Jung Jang Han, Yang Min Jae, Park Da Hae
Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong-si, Gyeonggi-do 18450, Korea.
Department of Gastroenterology, Ajou University School of Medicine, 164, Worldcup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do 16499, Korea.
J Pers Med. 2021 Jan 17;11(1):55. doi: 10.3390/jpm11010055.
Novel slim biopsy forceps provide some technical advantages to facilitate a more accurate diagnosis, although we are not aware of any comparative studies. Therefore, we compared tissue acquisition and diagnostic accuracy between novel slim biopsy forceps and conventional biopsy forceps in cases with a biliary stricture. We reviewed 341 patients who underwent endoscopic retrograde cholangiopancreatography for the histological confirmation of biliary stricture at two tertiary hospitals between 2013 and 2020. The primary endpoint was the forceps' diagnostic accuracies. We included 276 patients who underwent biopsy using the novel forceps ( = 130) or conventional forceps ( = 146). The novel forceps provided 81.7% sensitivity, 100.0% specificity, positive-predictive value (PPV) of 100.0%, and negative-predictive value (NPV) of 57.8%, with an accuracy of 85.4% when the diagnosis by endobiliary biopsy included suspected or positive malignancy. The conventional forceps provided 61.7% sensitivity, 100.0% specificity, PPV of 100.0%, and NPV of 36.1%, with an accuracy of 68.5%. Only novel forceps use was significantly associated with an accurate diagnosis (odds ratio: 2.70, 95% confidence interval: 1.52-5.00). There were no significant inter-group differences in the procedure-related rates of adverse events. Endobiliary biopsy using novel forceps offered better diagnostic performance and more acceptable procedure-related adverse events than conventional forceps.
新型纤细活检钳具有一些技术优势，有助于做出更准确的诊断，尽管我们尚未了解任何比较研究。因此，我们比较了新型纤细活检钳和传统活检钳在胆管狭窄病例中的组织获取情况和诊断准确性。我们回顾了2013年至2020年期间在两家三级医院接受内镜逆行胰胆管造影术以进行胆管狭窄组织学确诊的341例患者。主要终点是活检钳的诊断准确性。我们纳入了276例使用新型活检钳（n = 130）或传统活检钳（n = 146）进行活检的患者。当胆管内活检诊断包括疑似或阳性恶性肿瘤时，新型活检钳的灵敏度为81.7%，特异度为100.0%，阳性预测值（PPV）为100.0%，阴性预测值（NPV）为57.8%，准确率为85.4%。传统活检钳的灵敏度为61.7%，特异度为100.0%，PPV为100.0%。，NPV为36.1%，准确率为68.5%。仅使用新型活检钳与准确诊断显著相关（优势比：2.70，95%置信区间：1.52 - 5.00）。两组在与操作相关的不良事件发生率方面无显著差异。与传统活检钳相比，使用新型活检钳进行胆管内活检具有更好的诊断性能和更可接受的与操作相关的不良事件。
