value of bile cytology in the diagnosis and early detection of malignancy in patients with obstructive jaundice

ABSTRACT

Bile was aspirated from 20 patients suffering from obstructive jaundice [10- males and 10 females] during endoscopic cholangiography [ERCP]. The patients were assessed clinically, by laboratory investigations, abdominal ultrasonography, ERCP, operative biopsy and by cytology. This is to determine the presence of malignancy as an underlying cause for the obstruction and to evaluate the diagnostic accuracy of bile cytology obtained during ERCP. The results of 19 cases were divided into two main groups where group A consisted of 10 malignant cases and 5 benign cases. One case showed false positive diagnosis and no false negative. Group B included 4 atypical smears which were considered benign until proved otherwise [I proved histologically benign the others were found to be malignant]. The sensitivity calculated for group A was 100% and 75% for group B, the specificity was 83.3% for A and 85.7% for B. The diagnostic accuracy was 93.3% for A and 78.9 for group B. The results of this pilot study are quite encouraging with respect to the reliability of diagnosis of bile samples particularly in association with ERCP, it can be considered as a simple reliable, rapid method for preoperative evaluation of patients with obstructive jaundice and for the early detection of malignancy in screening programs