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Endoscopic retrograde cholangiopancreatography-guided brush cytology diagnosis of pancreatobiliary tumors / 中华病理学杂志
Chinese Journal of Pathology ; (12): 189-193, 2009.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-319755
Biblioteca responsável: WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To study the cytologic features of pancreatobiliary tumors in endoscopic retrograde cholangiopancreatography (ERCP)-guided brushing preparations and to evaluate the usefulness of cytology in the diagnosis of pancreatobiliary malignancy.</p><p><b>METHODS</b>A retrospective analysis of 212 cases of ERCP-guided brush cytology smears performed during the period from January, 2004 to December, 2006. The cytologic diagnosis was confirmed either by the histologic diagnosis or the strict clinical criteria.</p><p><b>RESULTS</b>Two of the cases studied were unsatisfactory for diagnosis, with no epithelial cells identified. One hundred and thirty-seven smears were diagnosed as "negative", 45 of which subsequently confirmed to be malignant (negative predictive value = 60.2%). Six of the 11 cases with "low-grade atypia" were proven to be malignant (positive predictive value = 54.5%), as compared to 19 of 23 cases of "high-grade atypia" (positive predictive value = 86.4%). All of the 41 cases with cytologic diagnosis of "malignancy" were confirmed to be malignant (positive predictive value = 100%). The cytologic features of malignancy in ERCP-guided brushing preparations included overlapping nuclei, anisonucleosis, coarse chromatin pattern, poor cellular cohesion, tumor diathesis, prominent nucleoli and atypical mitotic figures.</p><p><b>CONCLUSIONS</b>The accuracy of ERCP-guided brush cytology relies on good specimen preparation and application of morphologic criteria. Grading of cytologic atypia is of clinical significance. A "negative" or "low-grade atypia" cytologic diagnosis requires further diagnostic workup to rule out the possibility of underlying malignancy, while a "high-grade atypia" or "malignant" diagnosis is relatively specific in guiding subsequent management of suspected pancreatobiliary malignancy.</p>
Assuntos
Texto completo: Disponível Base de dados: WPRIM (Pacífico Ocidental) Assunto principal: Neoplasias Pancreáticas / Patologia / Lesões Pré-Cancerosas / Manejo de Espécimes / Cirurgia Geral / Neoplasias do Sistema Biliar / Biópsia / Adenocarcinoma / Valor Preditivo dos Testes / Estudos Retrospectivos Tipo de estudo: Estudo diagnóstico / Estudo observacional / Estudo prognóstico Limite: Adolescente / Adulto / Idoso / Idoso, 80 anos ou mais / Feminino / Humanos / Masculino Idioma: Chinês Revista: Chinese Journal of Pathology Ano de publicação: 2009 Tipo de documento: Artigo
Texto completo: Disponível Base de dados: WPRIM (Pacífico Ocidental) Assunto principal: Neoplasias Pancreáticas / Patologia / Lesões Pré-Cancerosas / Manejo de Espécimes / Cirurgia Geral / Neoplasias do Sistema Biliar / Biópsia / Adenocarcinoma / Valor Preditivo dos Testes / Estudos Retrospectivos Tipo de estudo: Estudo diagnóstico / Estudo observacional / Estudo prognóstico Limite: Adolescente / Adulto / Idoso / Idoso, 80 anos ou mais / Feminino / Humanos / Masculino Idioma: Chinês Revista: Chinese Journal of Pathology Ano de publicação: 2009 Tipo de documento: Artigo
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