Factors Associated with Malignant Biliary Strictures in Patients with Atypical or Suspicious Cells on Brush Cytology
Background/Aims Pathological diagnosis of biliary strictures with atypical or suspicious cells on endoscopic retrograde brush cytology and indeterminate strictures on imaging is challenging. The aim of this study was to identify markers for malignant strictures in such cases. Methods We retrospectiv...
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| Format: | Article |
| Language: | English |
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Korean Society of Gastrointestinal Endoscopy
2019-03-01
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| Series: | Clinical Endoscopy |
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| Online Access: | http://www.e-ce.org/upload/pdf/ce-2018-105.pdf |
| _version_ | 1797423621730205696 |
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| author | Ji Young Park Tae Joo Jeon |
| author_facet | Ji Young Park Tae Joo Jeon |
| author_sort | Ji Young Park |
| collection | DOAJ |
| description | Background/Aims Pathological diagnosis of biliary strictures with atypical or suspicious cells on endoscopic retrograde brush cytology and indeterminate strictures on imaging is challenging. The aim of this study was to identify markers for malignant strictures in such cases. Methods We retrospectively analyzed data collected from 146 consecutive patients with indeterminate biliary strictures on imaging who underwent endoscopic retrograde brush cytology from 2007 to 2013. Factors associated with malignant strictures in patients with atypical or suspicious cells on brush cytology were identified. Results Among the 67 patients with a malignant disease (48 cholangiocarcinoma, 6 gallbladder cancer, 5 pancreatic cancer, 5 ampulla of Vater cancer, and 3 other types), 36 (53.7%) had atypical or suspicious cells on brush cytology. Among these, the factors that independently correlated with malignant strictures were stricture length (odds ratio [OR], 5.259; 95% confidence interval [CI], 1.802– 15.294) and elevated carbohydrate antigen 19-9 (CA19-9) (OR, 3.492; 95% CI, 1.242–9.815), carcinoembryonic antigen (CEA) (OR, 4.909; 95% CI, 1.694–14.224), alkaline phosphatase (ALP) (OR, 3.362; 95% CI, 1.207–9.361), and gamma-glutamyl transpeptidase (rGT) (OR, 4.318; 95% CI, 1.512–12.262). Conclusions Elevated levels of CA19-9, CEA, ALP, and rGT and stricture length are associated with malignant strictures in patients with indeterminate biliary strictures on imaging and atypical or suspicious cells on brush cytology. |
| first_indexed | 2024-03-09T07:50:35Z |
| format | Article |
| id | doaj.art-457227fb97fd473b891f98e461de46d0 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-09T07:50:35Z |
| publishDate | 2019-03-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-457227fb97fd473b891f98e461de46d02023-12-03T01:52:03ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432019-03-0152216817410.5946/ce.2018.1057182Factors Associated with Malignant Biliary Strictures in Patients with Atypical or Suspicious Cells on Brush CytologyJi Young Park0Tae Joo Jeon Division of Gastroenterology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, KoreaBackground/Aims Pathological diagnosis of biliary strictures with atypical or suspicious cells on endoscopic retrograde brush cytology and indeterminate strictures on imaging is challenging. The aim of this study was to identify markers for malignant strictures in such cases. Methods We retrospectively analyzed data collected from 146 consecutive patients with indeterminate biliary strictures on imaging who underwent endoscopic retrograde brush cytology from 2007 to 2013. Factors associated with malignant strictures in patients with atypical or suspicious cells on brush cytology were identified. Results Among the 67 patients with a malignant disease (48 cholangiocarcinoma, 6 gallbladder cancer, 5 pancreatic cancer, 5 ampulla of Vater cancer, and 3 other types), 36 (53.7%) had atypical or suspicious cells on brush cytology. Among these, the factors that independently correlated with malignant strictures were stricture length (odds ratio [OR], 5.259; 95% confidence interval [CI], 1.802– 15.294) and elevated carbohydrate antigen 19-9 (CA19-9) (OR, 3.492; 95% CI, 1.242–9.815), carcinoembryonic antigen (CEA) (OR, 4.909; 95% CI, 1.694–14.224), alkaline phosphatase (ALP) (OR, 3.362; 95% CI, 1.207–9.361), and gamma-glutamyl transpeptidase (rGT) (OR, 4.318; 95% CI, 1.512–12.262). Conclusions Elevated levels of CA19-9, CEA, ALP, and rGT and stricture length are associated with malignant strictures in patients with indeterminate biliary strictures on imaging and atypical or suspicious cells on brush cytology.http://www.e-ce.org/upload/pdf/ce-2018-105.pdfBrush cytologyBiliary strictureAtypical cellSuspicious cell |
| spellingShingle | Ji Young Park Tae Joo Jeon Factors Associated with Malignant Biliary Strictures in Patients with Atypical or Suspicious Cells on Brush Cytology Clinical Endoscopy Brush cytology Biliary stricture Atypical cell Suspicious cell |
| title | Factors Associated with Malignant Biliary Strictures in Patients with Atypical or Suspicious Cells on Brush Cytology |
| title_full | Factors Associated with Malignant Biliary Strictures in Patients with Atypical or Suspicious Cells on Brush Cytology |
| title_fullStr | Factors Associated with Malignant Biliary Strictures in Patients with Atypical or Suspicious Cells on Brush Cytology |
| title_full_unstemmed | Factors Associated with Malignant Biliary Strictures in Patients with Atypical or Suspicious Cells on Brush Cytology |
| title_short | Factors Associated with Malignant Biliary Strictures in Patients with Atypical or Suspicious Cells on Brush Cytology |
| title_sort | factors associated with malignant biliary strictures in patients with atypical or suspicious cells on brush cytology |
| topic | Brush cytology Biliary stricture Atypical cell Suspicious cell |
| url | http://www.e-ce.org/upload/pdf/ce-2018-105.pdf |
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