Korean J Gastroenterol.  2014 Apr;63(4):223-230. 10.4166/kjg.2014.63.4.223.

Diagnostic Accuracy of Brush Cytology with Direct Smear and Cell-block Techniques according to Preparation Order and Tumor Characteristics in Biliary Strictures

• Jo YG
• Lee TH
• Cho HD
• Park SH
• Park JM
• Cho YS
• Jung Y
• Chung IK
• Choi HJ
• Moon JH
• Cha SW
• Cho YD
• Kim SJ

• KMID: 1791879
• DOI: http://doi.org/10.4166/kjg.2014.63.4.223

Abstract

BACKGROUND/AIMS
There are few data supporting the diagnostic yield of brush cytology depending on the order of cytologic preparation method or the location or shape of tumors in biliary strictures. We investigated diagnostic yields and variations in brush cytology with direct smear and cell-block preparations according to sampling preparation sequence and tumor location and shape in biliary strictures.
METHODS
Patients who had undergone ERCP with tissue sampling between August 2009 and April 2013 were analyzed retrospectively. Group A was examined using brush cytology with direct smear followed by cell-block with or without biopsy, while the reverse order was performed for group B.
RESULTS
Among 138 enrolled patients, 92 patients (A: 36, B: 56) underwent both brush cytology with direct smear and cell-block preparations. No differences in sensitivity, specificity, or accuracy were observed according to the sampling preparation method and the location or shape of tumors in biliary strictures. The cellularity observed from brush cytology with direct smear was better than that from cell-block according to the location of the tumor (p<0.01). The diagnostic yield was increased in both groups with addition of an endobiliary biopsy.
CONCLUSIONS
No difference in diagnostic accuracy was observed between the sequences of preparation for brush cytology with direct smear and cell-block techniques. Brush cytology showed better cellularity for diagnosis.

Keyword

Biliary stricture; Brush cytology; Cell-block

MeSH Terms

Aged
Aged, 80 and over
Bile Duct Neoplasms/*pathology
Cholangiocarcinoma/pathology
Cholangiopancreatography, Endoscopic Retrograde
*Cytodiagnosis
Female
Gallbladder Neoplasms/pathology
Humans
Male
Middle Aged
Neoplasm Staging
Pancreatic Neoplasms/pathology
Retrospective Studies
Sensitivity and Specificity

Reference

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