P-128 - Efficacy of Various Endoscopic Transpapillary Sampling Methods for Malignant Biliary Lesions

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Hepatobiliary Cancers
Surgery and/or Radiotherapy of Cancer
Presenter J.J. Hyun
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors J.J. Hyun1, H.S. Choi1, H.J. Chun1, I.K. Yoo1, J.M. Lee1, S.H. Kim1, E.S. Kim1, B. Keum1, Y.T. Jeen2, H.S. Lee1, C.D. Kim1, S.J. Nam1, H.S. Ryu1
  • 1Korea University College of Medicine, Seoul/KR
  • 2Department of Internal Medicine, Seoul/KR

Abstract

Introduction

Various methods for endoscopic transpapillary sampling have been developed. However, the accuracy rate of these methods for bile duct cancer is controversial. The aim of the present study was to determine the factors affecting the accuracy of endoscopic transpapillary sampling methods.

Methods

We reviewed the results from 92 patients with bile duct cancer who underwent transpapillary sampling by aspiration bile cytology, brushing cytology, and fluoroscopic forceps biopsy. The final diagnosis of bile duct cancer was made on the basis of pathological evaluation of specimens obtained at surgery or the clinical course over at least 1 year in patients not operated. We carried out subgroup analyses for the factors affecting the accuracy of each transpapillary sampling method.

Results

Transpapillary biopsy (71.2%) had a significantly higher level of sensitivity for cholangiocarcinoma than brush cytology (58.8%) and bile cytology (62.5%). Bile cytology (85.7%) showed higher diagnostic yield for pancreatic cancer with bile duct invasion than transpapillary biopsy (60%) and brush cytology (66.7%). In patients with negative biopsy results, bile cytology had higher diagnostic yield than brush cytology.

Conclusion

Transpapillary bile duct biopsy is a simple, safe, and effective technique for diagnosing biliary malignant lesion. It showed more sensitive for cholangiocarcinoma than for pancreatic cancer with bile duct invasion. After negative biopsy result, bile cytology presented higher diagnostic yield.