与传统涂片和钳取活检相比，液基细胞学在诊断胆管癌中的效用。

Usefulness of Liquid-Based Cytology in Diagnosing Biliary Tract Cancer Compared to Conventional Smear and Forceps Biopsy.

作者信息

Lee Min Woo, Paik Woo Hyun, Lee Sang Hyub, Chun Jung Won, Huh Gunn, Park Nam Young, Kim Joo Seong, Cho In Rae, Ryu Ji Kon, Kim Yong Tae, Kim Haeryoung, Lee Kyoungbun

机构信息

Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

Department of Pathology, Seoul National University Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

出版信息

Dig Dis Sci. 2023 Jan;68(1):274-283. doi: 10.1007/s10620-022-07535-3. Epub 2022 May 20.

DOI:10.1007/s10620-022-07535-3

PMID:35596035

Abstract

BACKGROUND/AIMS: Liquid-based cytology (LBC) has been shown to improve the diagnostic efficacy of brush cytology for thyroid, cervical and pancreatic cancer. To evaluate the diagnostic performance of LBC for biliary tract cancer, we compared it with conventional smears and forceps biopsies.

METHODS

A retrospective study was conducted of all consecutive patients who underwent brush cytology under ERCP from January 2010 to April 2020. The primary outcome was the diagnostic efficacy of conventional smears and LBC. The difference between the two groups was corrected using inverse probability weighting (IPW). The secondary outcome was the sensitivity and specificity of brush cytology and forceps biopsy. The secondary outcome was evaluated in patients who underwent both methods.

RESULTS

Among 162 patients, conventional smears were performed in 70 patients and LBC was performed in 92 patients. In the primary analysis using IPW, the sensitivity of conventional smears and LBC was 56.00% and 78.26% respectively (P = 0.009). The specificity was 100% for both methods. The accuracy was 66.15% for conventional smears and 83.33% for LBC (P = 0.012). In the secondary analysis, the sensitivity of conventional smears versus forceps biopsies was 62.16% versus 78.38% (P = 0.034) and 81.16% for both LBC and forceps biopsies. The specificity of both cytological examination and forceps biopsies was 100%.

CONCLUSIONS

Liquid-based cytology demonstrated better sensitivity and accuracy than conventional smears. Moreover, its diagnostic performance was close to that of forceps biopsies.

摘要

背景/目的：液基细胞学检查（LBC）已被证明可提高甲状腺癌、宫颈癌和胰腺癌刷片细胞学检查的诊断效能。为评估LBC对胆管癌的诊断性能，我们将其与传统涂片和钳取活检进行了比较。

方法

对2010年1月至2020年4月期间在ERCP下接受刷片细胞学检查的所有连续患者进行回顾性研究。主要结局是传统涂片和LBC的诊断效能。两组之间的差异采用逆概率加权法（IPW）进行校正。次要结局是刷片细胞学检查和钳取活检的敏感性和特异性。次要结局在同时接受这两种检查方法的患者中进行评估。

结果

162例患者中，70例进行了传统涂片，92例进行了LBC。在使用IPW的初步分析中，传统涂片和LBC的敏感性分别为56.00%和78.26%（P = 0.009）。两种方法的特异性均为100%。传统涂片的准确率为66.15%，LBC的准确率为83.33%（P = 0.012）。在次要分析中，传统涂片与钳取活检的敏感性分别为62.16%和78.38%（P = 0.034），LBC和钳取活检的敏感性均为81.16%。细胞学检查和钳取活检的特异性均为100%。