两种用于疑似恶性胆道狭窄的导管内胆道刷细胞学装置的顺序比较

IF 2.4 Q3 GASTROENTEROLOGY & HEPATOLOGY Frontline Gastroenterology Pub Date : 2024-03-13 DOI:10.1136/flgastro-2023-102627
Manu Nayar, Kofi W Oppong, Pardeep Maheshwari, Sarah Johnson, Shiran Esmaily, Ruth Waller, John Leeds
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引用次数: 0

摘要

背景内镜逆行胰胆管造影刷细胞学对恶性狭窄的诊断效果一般。一种新型的更大更耐磨的刷子可能会提高诊断效果。我们比较了新型胆道刷和传统刷的效用。方法 在 51 名连续转诊的胆道狭窄患者(第 1 组)中使用新型刷子,并与 102 名使用传统刷子取样的患者(第 2 组)进行比对。对人口统计学数据、胆道狭窄特征、敏感性、特异性、阴性预测值和阳性预测值进行了分析,并与最终诊断结果进行了比较。分析采用严格标准(确定为癌症)和宽松标准(怀疑为癌症)。所有患者的随访时间至少为 12 个月。结果 两组患者的年龄和性别分布差异无统计学意义。两组患者中均有 74% 确诊为恶性肿瘤。采用严格标准(敏感性第一组 47.4% 对第二组 52%,P=0.69)或宽松标准(敏感性第一组 71.1% 对第二组 71.2%,P=1.0),两组的敏感性无明显差异。结论 我们的数据表明,在以稳健的方式进行比较时,新型刷子设计并不能提高恶性胆道狭窄的诊断性能。这凸显了导管内刷取样的困难以及开发新诊断技术的必要性。如有合理要求,可提供相关数据。
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Sequential comparison of two intraductal biliary brush cytology devices for suspected malignant biliary strictures
Background The diagnostic performance of endoscopic retrograde cholangiopancreatography brush cytology for malignant strictures is modest. A novel larger more abrasive brush may have improved diagnostic performance. We compared the utility of the new biliary brush with a conventional brush. Methods The new brush was used in 51 consecutive patients (group 1) referred with a biliary stricture and matched to 102 patients who underwent sampling with a conventional brush (group 2). Demographic data, stricture characteristics, sensitivity, specificity, negative predictive values and positive predictive values were analysed and compared with final diagnosis. Analysis was performed using strict criteria (definite for cancer) and relaxed criteria (suspicious for cancer). All patients had a minimum follow-up of 12 months. Results There was no statistically significant difference in the age and sex distribution between the two groups. Malignancy was diagnosed in 74% in both groups. There was no significant difference in sensitivity between the groups using either strict criteria (sensitivity group 1 47.4% vs group 2 52%, p=0.69) or relaxed criteria (sensitivity group 1 71.1% vs group 2 71.2%, p=1.0). Conclusions Our data suggest that the novel brush design does not confer improved diagnostic performance in malignant biliary strictures when compared in a robust manner. This highlights the difficulties of intraductal brush sampling and the need to develop newer diagnostic techniques. Data are available upon reasonable request.
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来源期刊
Frontline Gastroenterology
Frontline Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.70
自引率
11.50%
发文量
93
期刊介绍: Frontline Gastroenterology publishes articles that accelerate adoption of innovative and best practice in the fields of gastroenterology and hepatology. Frontline Gastroenterology is especially interested in articles on multidisciplinary research and care, focusing on both retrospective assessments of novel models of care as well as putative future directions of best practice. Specifically Frontline Gastroenterology publishes articles in the domains of clinical quality, patient experience, service provision and medical education.
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