The Korean Journal of Cytopathology (대한세포병리학회지)

The Korean Society for Cytopathology (대한세포병리학회)
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Utility of Bile Duct Brush Cytology in Pancreaticobiliary Diseases - Prospective Comparative Study of Conventional Smear and $MonoPrep2^{TM}$ Liquid Based Cytology -

췌담관질환에서 담관 솔질세포검사의 유용성 - 통상도말과 $MonoPrep2^{TM}$ 액상세포검사의 전향적 비교연구 -

  • Lee, Dong-Wha (Department of Pathology, Soonchunhyang University Hospital) ;
  • Kim, Mee-Sun (Department of Pathology, Soonchunhyang University Hospital) ;
  • Cho, Young-Deok (Department of Internal Medicine, Soonchunhyang University Hospital) ;
  • Cheon, Young-Koog (Department of Internal Medicine, Soonchunhyang University Hospital) ;
  • Choi, Min-Sung (Department of Pathology, Soonchunhyang University Hospital) ;
  • Kim, Dong-Won (Department of Pathology, Soonchunhyang University Hospital) ;
  • Jin, So-Young (Department of Pathology, Soonchunhyang University Hospital)
  • 이동화 (순천향대학교병원 병리과) ;
  • 김미선 (순천향대학교병원 병리과) ;
  • 조영덕 (순천향대학교병원 내과) ;
  • 천영국 (순천향대학교병원 내과) ;
  • 최민성 (순천향대학교병원 병리과) ;
  • 김동원 (순천향대학교병원 병리과) ;
  • 진소영 (순천향대학교병원 병리과)
  • Published : 2006.03.31
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Abstract

Bile duct brush cytology has been employed as a diagnostic tool for the evaluation of pancreatic and biliary tract strictures. The specificity of this method is high however, its sensitivity is quite low. A recent study employing liquid based cytology (LBC) reported results comparable to those achieved via conventional cytology. Therefore, we have attempted to prospectively evaluate the diagnostic utility of bile duct brush cytology in pancreaticobiliary diseases. A total of 46 cases with bile duct stricture were enrolled including 11 cases of benign stricture, 29 cases of bile duct carcinoma, 3 cases of gallbladder cancer, and 3 cases of pancreatic cancer. Both conventional smear and LBC using $MonoPrep2^{TM}$ system were conducted in each case. The cytological diagnosis of each case was classed into the following categories; benign, suspicious for malignancy, and malignancy. The diagnostic accuracy of both cytologic methods was investigated. LBC evidenced a high rate of material insufficiency (13/46), which was attributed to low cellularity. The kappa index of both cytological methods was 0.508. Cytological and tissue diagnoses were correlated in 25 cases conducted from biopsy or operation. The sensitivity, specificity, positive predictive value, and negative predictive value were 41.2% (7/17), 100% (8/8), 100% (7/7), and 44.4% (10/18) in conventional smear; 58.8% (10/17), 87.5% (7/8), 90.9% (10/11), and 50.0% (7/14) in LBC; and 94.1% (16/17), 87.5% (7/8), 94.1% (16/17), and 87.5% (7/8) in any one of both cytological methods, respectively. Based on these results, the sensitivity of LBC was found to be superior to that of conventional smear and we were able to obtain higher positive predictive value upto 94.1% by simultaneously conducting both cytologic methods.

Keywords

References

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