Endoscopic transpapillary brush cytology and forceps biopsy in patients with hilar cholangiocarcinoma.
OBJECTIVE
To evaluate the sensitivity of brush cytology and forceps biopsy in a homogeneous patient group with hilar cholangiocarcinoma.


METHODS
Brush cytology and forceps biopsy were routinely performed in patients with suspected malignant biliary strictures. Fifty-eight consecutive patients undergoing endoscopic retrograde cholangio-pancreatography (ERCP) including forceps biopsy and brush cytology in patients with hilar cholangiocarcinoma between 1995-2005.


RESULTS
Positive results for malignancy were obtained in 24/58 patients (41.4%) by brush cytology and in 31/58 patients (53.4%) by forceps biopsy. The combination of both techniques brush cytology and forceps biopsy resulted only in a minor increase in diagnostic sensitivity to 60.3% (35/58 patients). In 20/58 patients (34.5%), diagnosis were obtained by both positive cytology and positive histology, in 11/58 (19%) by positive histology (negative cytology) and only 4/58 patients (6.9%) were confirmed by positive cytology (negative histology).


CONCLUSIONS
Brush cytology and forceps biopsy have only limited sensitivity for the diagnosis of malignant hilar tumors. In our eyes, additional diagnostic techniques should be evaluated and should become routine in patients with negative cytological and histological findings.
Weber
Andreas
A
Department of Internal Medicine II, Technical University of Munich, Ismaningerstrasse 22, Munchen 81675, Germany.
von Weyhern
Claus
C
Fend
Falko
F
Schneider
Jochen
J
Neu
Bruno
B
Meining
Alexander
A
Weidenbach
Hans
H
Schmid
Roland M
RM
Prinz
Christian
C
D000368:Aged; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000473:pathology; D017734:Bile Ducts, Extrahepatic; D001706:Biopsy / Q000379:methods; D018281:Cholangiocarcinoma / Q000175:diagnosis* / Q000473:pathology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003581:Cytodiagnosis / Q000379:methods; D016145:Endoscopy, Digestive System / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013525:Surgical Instruments