液基细胞学与传统细胞学方法诊断胆总管恶性狭窄的对比研究

Diagnosis of malignant stricture of common bile duct： liquid-based cytology versus conventional cytology

目的探讨液基细胞学方法对胆总管恶性狭窄的诊断价值。方法对2008年10月至2009年6月间影像学怀疑为胆总管恶性狭窄的患者进行ERCP胆管细胞刷刷检，分别采用液基细胞学、传统细胞学方法进行细胞学标本制备，比较两种方法诊断的阳性率。结果疑诊胆总管恶性狭窄患者76例，经手术病理、细胞学检测及临床随访最终明确诊断为胆总管恶性狭窄的共65例。32例细胞学检测明确诊断的患者中，传统细胞学方法发现阳性17例（阳性率为26．2％，17／65）、液基细胞学方法发现阳性32例（阳性率为49．2％，32／65），两者阳性率比较差异有统计学意义（P〈0．05）。结论液基细胞学较传统细胞学方法可提高ERCP胆管细胞刷刷检标本的阳性发现率，具有较高的临床应用价值。

Objective To evaluate the diagnostic value of liquid-based cytology in malignant stricture of common bile duct. Methods Between October 2008 and June 2009, patients suspected of having malignant stricture of common bile duct underwent brushing through endoscopic retrograde cholangiopancreatography （ERCP）. Specimens were processed in two ways, liquid-based and conventional cytology, and positive diagnostic rates were compared. Results Among 76 cases of suspected malignant bile duct stricture, 65 were confirmed via surgical pathology, cytology tests or follow-up. Of all the 32 cases which were confirmed by cytology tests, 17 （26.2% , 17/65） were through conventional cytology, and 32 （49. 2%, 32/65） through liquid-based cytology, which were significantly different （ P 〈 0. 05 ）. Conclusion Compared with conventional cytology, liquid-based cytology can improve positive diagnostic rate of brushing during ERCP.