Diagnosis of Biliary Strictures in Conjunction with Endoscopic Retrograde Cholangiopancreaticography, with Special Reference to Patients with Primary Sclerosing Cholangitis
| Autor: | Hansson Lo, B. Persson, Broomé U, B Tribukait, Hjerpe A, Bo Lindberg, S. Granqvist, Annika Bergquist, Thörne A, Urban Arnelo |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Diagnostic methods CA-19-9 Antigen Cytodiagnosis Cholangitis Sclerosing Constriction Pathologic Malignancy Bile fluid Sensitivity and Specificity digestive system Gastroenterology Primary sclerosing cholangitis Cholangiocarcinoma Bile Ducts Extrahepatic Internal medicine Cytology medicine Humans In patient Aged Aged 80 and over Cholangiopancreatography Endoscopic Retrograde Ploidies medicine.diagnostic_test business.industry Brush cytology Middle Aged medicine.disease digestive system diseases Carcinoembryonic Antigen Endoscopy Bile Ducts Intrahepatic Biliary Tract Neoplasms Female Bile Ducts business |
| Zdroj: | Endoscopy. 34:909-916 |
| ISSN: | 1438-8812 0013-726X |
| DOI: | 10.1055/s-2002-35298 |
| Popis: | Background and study aims Strictures of the bile ducts due to malignant changes are difficult to distinguish from benign changes, particularly in patients with primary sclerosing cholangitis (PSC). The aim of this study was to evaluate diagnostic methods for malignancy in biliary strictures in conjunction with endoscopic retrograde cholangiopancreaticography (ERCP). Patients and methods Bile duct strictures were identified during ERCP in 57 patients, who were thus included in the present study. Brush samples from the strictures were taken for cytology and for evaluation of DNA content by flow cytometry. The tumor markers CA 19-9 and CEA were determined both in serum and bile fluid. Two independent radiologists evaluated all cholangiograms. The diagnostic sensitivity, specificity, and accuracy of each diagnostic method were evaluated separately and in combination. Results 32 patients were found to have malignant strictures and when the four methods: brush cytology, DNA analysis, serum CA 19-9 and serum CEA were combined, a diagnostic sensitivity of 88 % and specificity of 80 % were reached. Seven of the 20 patients with PSC were found also to suffer from cholangiocarcinoma, yielding a sensitivity and specificity of 100 % and 85 %, respectively. Analyses of CA 19-9 and CEA in bile fluid had no diagnostic significance. Conclusion An ERCP procedure with brush cytology, a DNA analysis, combined with serum analysis of CA 19-9 and CEA, can increase the possibility of distinguishing between malignant and benign biliary strictures, especially in PSC patients. |
| Databáze: | OpenAIRE |
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