title: Endoscopic transpapillary brush cytology and forceps biopsy in patients with hilar cholangiocarcinoma.
abstract: 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.
authors.affiliation: Department of Internal Medicine II, Technical University of Munich, Ismaningerstrasse 22, Munchen 81675, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Weber
authors.forename: Claus
authors.initials: C
authors.lastname: von Weyhern
authors.forename: Falko
authors.initials: F
authors.lastname: Fend
authors.forename: Jochen
authors.initials: J
authors.lastname: Schneider
authors.forename: Bruno
authors.initials: B
authors.lastname: Neu
authors.forename: Alexander
authors.initials: A
authors.lastname: Meining
authors.forename: Hans
authors.initials: H
authors.lastname: Weidenbach
authors.forename: Roland M
authors.initials: RM
authors.lastname: Schmid
authors.forename: Christian
authors.initials: C
authors.lastname: Prinz
mesh_terms: 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