Prediction of the histologic type of bile duct cancer by using intraductal ultrasonography.
BACKGROUND
Patients with papillary adenocarcinoma survive longer than do patients with other histologic types of bile duct tumors. We evaluated the usefulness of intraductal ultrasonography (IDUS) for predicting the histology.


METHODS
Preoperative tumor assessment was performed by using IDUS through a percutaneous tract or the transpapillary route in 37 patients with extrahepatic bile duct cancer. In 30 of 37 patients, imaging results were compared prospectively with histologic findings in resected specimens. Probes 2.0 mm in diameter and 20 MHz in frequency were mainly used. When IDUS showed a "narrow-based polypoid pattern" or a "papillary surface pattern," the patients were judged as having papillary adenocarcinoma.


RESULTS
The accuracy, sensitivity, and specificity of IDUS in predicting papillary adenocarcinoma were 90%, 89%, and 90%, respectively. When intraductal ultrasonography showed a papillary surface pattern or a narrow-based polypoid pattern, lymph node metastases and perineural invasion were rarely seen when compared with other patients with bile duct cancer (p < 0.05).


CONCLUSIONS
IDUS is useful for assessing the histologic type of bile duct cancer.
Tamada
K
K
Department of Gastroenterology, Jichi Medical School, Yakushiji, Tochigi 329-0498, Japan.
Kanai
N
N
Tomiyama
T
T
Ohashi
A
A
Wada
S
S
Satoh
Y
Y
Miyata
T
T
Tano
S
S
Ido
K
K
Sugano
K
K
D000231:Adenocarcinoma, Papillary / Q000000981:diagnostic imaging* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D017734:Bile Ducts, Extrahepatic / Q000000981:diagnostic imaging / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003937:Diagnosis, Differential; D004384:Duodenoscopy; D019160:Endosonography / Q000379:methods; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012189:Retrospective Studies