Hormati Ahmad, Jafari Saeede, Jabbari Amir, Pezeshki Modares Mahdi, Afifian Mahboubeh, Abasi Ahmad, Ahmadpour Sajjad, Sharifi Ali Reza
Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Sciences, Qom, Iran.
Gastrointestinal and Liver diseases Research Center, Iran university of Medicine Sciences, Tehran, Iran.
Middle East J Dig Dis. 2020 Oct;12(4):246-251. doi: 10.34172/mejdd.2020.189.
BACKGROUND Cholangiocarcinoma is the second most common malignant liver cancer. Its early diagnosis plays an important role in the success of treatment. The aim of this study was to compare the use of cold forceps biopsy without cholangioscopy with brush cytology in the diagnosis of cholangiocarcinoma. METHODS In this prospective study, we enrolled 19 patients. Endoscopic retrograde cholangiopancreatography (ERCP) was performed for all individuals. Sampling was performed from the narrowing site using the brush method. Then, a cold forceps biopsy was performed under fluoroscopy. RESULTS The mean age of the patients was 63.31 ± 11.12 years and most of them were men (63.16 %). The brush cytology and the cold forceps biopsy diagnosed 31.85% and 68.42% of the samples as cholangiocarcinoma, respectively. According to the McNemar test, there was a statistically significant difference between the diagnostic results of the brush cytology and cold forceps biopsy. So that more cholangiocarcinoma cases were diagnosed using forceps biopsy ( = 0.016). No complications such as perforation, bleeding, cholangitis, and leakage were reported during the cold forceps procedure. CONCLUSION Cold forceps biopsy under fluoroscopy is better than cytology brush in the diagnosis of proximal cholangiocarcinoma. It is recommended to be used as a low-cost alternative in cases where cholangioscopy is not available.
胆管癌是第二常见的肝脏恶性肿瘤。其早期诊断对治疗成功起着重要作用。本研究的目的是比较不使用胆管镜的冷活检钳活检与刷检细胞学在胆管癌诊断中的应用。
在这项前瞻性研究中，我们纳入了19例患者。对所有个体进行了内镜逆行胰胆管造影（ERCP）。使用刷检法从狭窄部位取样。然后，在荧光透视下进行冷活检钳活检。
患者的平均年龄为63.31±11.12岁，大多数为男性（63.16%）。刷检细胞学和冷活检钳活检分别将31.85%和68.42%的样本诊断为胆管癌。根据McNemar检验，刷检细胞学和冷活检钳活检的诊断结果之间存在统计学显著差异。因此，使用活检钳活检诊断出的胆管癌病例更多（P = 0.016）。在冷活检钳操作过程中未报告穿孔、出血、胆管炎和渗漏等并发症。
荧光透视下的冷活检钳活检在近端胆管癌诊断中优于细胞学刷检。建议在无法进行胆管镜检查的情况下将其作为低成本替代方法使用。
