Comparison Of The Value Of Endoscopic Sampling Methods In The Diagnosis Of Cholangiocarcinoma

Objective To evaluate the values of endoscopic retrograde brush cytology(ERBC) and dilatation catheter-guided mini-forceps biopsy(DCMB)in the diagnosis of malignant biliary stricture. To explore a feasible endoscopic bile ductal biopsy approach to acquire appropriate specimen for accurate pathological diagnosis of malignant biliary stricture.Methods Forty-two patients with malignant biliary stricture experienced endosocopic retrograde cholangiopancreatography(ERCP), and biliary tract stricture or obstruction was observed under the X-ray, then both ERBC and DCMB were carried out and the specimens were collected for pathological examination. Retrospective analysis of paired design was performed.Results Both ERBC and DCMB were performed in 42 patients successfully. Positive results for malignant biliary stricture were obtained in16/42 patients(38.09%) by ERBC and in 34/42 patients(80.95%) by DCMB.And there was statistical difference in the positive rate between the two methods(P<0.0001). The positive rate by the combination of ERBC and DCMB was 80.09%(34/42 patients). There DCMB had a higher positive rate was significantly higher in the 31 patients with cholangiocarcinoma than in those 11 with malignant tumors other than cholangiocarcinoma(87.1% vs63.64% P>0.05). In 42 patients, 18(42.86%) patients had positive histology but negative cytology and 0 patient had positive cytology but negative histology.Conclusion Endoscopic DCMB, a safe and cost-effective sampling method, can improve diagnostic sensitivity for malignant biliary stricture.