Alonso Lárraga Juan Octavio, Jiménez-Gutiérrez José Miguel, Meneses-Mayo Marcos, Hernández-Guerrero Angélica, Serrano-Arévalo Mónica Lizzette, Villegas-González Lidia Faridi
Endoscopia Gastrointestinal, Instituto Nacional de Cancerología, MEXICO.
Endoscopia Gastrointestinal, Instituto Nacional de Cancerología, Mexico.
Rev Esp Enferm Dig. 2025 Apr;117(4):198-204. doi: 10.17235/reed.2024.10719/2024.
diagnosing perihilar cholangiocarcinoma can be challenging. Previous studies suggest that the sensitivity of taking three cholangioscopy-guided biopsies is approximately 70 %. We hypothesized that obtaining four or more biopsies might improve the sensitivity for diagnosing perihilar cholangiocarcinoma.
to determine the acceptable number of cholangioscopy-guided biopsies to improve sensitivity for diagnosing perihilar cholangiocarcinoma.
this retrospective study analyzed clinical records of adults with perihilar stenosis who underwent cholangioscopy-guided biopsies. Patients with gallbladder cancer or metastatic bile duct obstruction were excluded. Data were grouped based on the number of biopsies taken: group A (one to three biopsies), group B (four to six biopsies), and group C (seven to ten biopsies). Results from each group were compared against a composite standard, including clinical follow-up and/or biopsies performed by alternative methods.
the group that underwent 4-6 biopsies had a sensitivity of 77.4 %, while the group with 7-10 biopsies had a sensitivity of 70.8 %. The group with 1-3 biopsies had a sensitivity of 34.5 %. Statistically significant differences were observed between the groups, with comparisons showing improved sensitivity in the 4-6 biopsy group versus the 1-3 biopsy group (χ² = 14.42, p = 0.0001), and the 7-10 biopsy group versus the 1-3 biopsy group (χ² = 6.56, p = 0.010).
performing four to six cholangioscopy-guided biopsies significantly improves sensitivity for diagnosing perihilar cholangiocarcinoma compared to one to three biopsies. Further studies are needed to validate these findings.
诊断肝门部胆管癌具有挑战性。先前的研究表明，进行三次经胆管镜引导活检的敏感性约为70%。我们推测获取四次或更多活检可能会提高肝门部胆管癌诊断的敏感性。
确定经胆管镜引导活检的可接受次数，以提高肝门部胆管癌诊断的敏感性。
这项回顾性研究分析了接受经胆管镜引导活检的肝门部狭窄成人患者的临床记录。排除患有胆囊癌或转移性胆管梗阻的患者。数据根据活检次数分组：A组（1至3次活检）、B组（4至6次活检）和C组（7至10次活检）。将每组结果与综合标准进行比较，综合标准包括临床随访和/或通过其他方法进行的活检。
进行4至6次活检的组敏感性为77.4%，而进行7至10次活检的组敏感性为70.8%。进行1至3次活检的组敏感性为34.5%。组间观察到统计学上的显著差异，比较显示4至6次活检组相对于1至3次活检组敏感性提高（χ² = 14.42，p = 0.0001），7至10次活检组相对于1至3次活检组敏感性提高（χ² = 6.56，p = 0.010）。
与1至3次活检相比，进行4至6次经胆管镜引导活检可显著提高肝门部胆管癌诊断的敏感性。需要进一步研究来验证这些发现。
