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首页> 美国卫生研究院文献>Endoscopy International Open >The ideal technique for processing SpyBite tissue specimens: a prospective single-blinded pilot-study of histology and cytology techniques
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The ideal technique for processing SpyBite tissue specimens: a prospective single-blinded pilot-study of histology and cytology techniques

机译：处理SpyBite组织标本的理想技术：组织学和细胞学技术的前瞻性单盲先导研究

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>Background and study aims  Diagnostic sensitivity for indeterminate biliary lesions remains suboptimal. Cytology techniques may mitigate the impediment of small cholangioscopic specimens. Our primary aim was to compare cell block cytology (CB) with standard histology for foregut SpyBite (SB) specimens. Our secondary aim was to assess CB in biliary SB biopsies. >Patients and methods  This was a two-phase prospective pilot study. In phase one, a prospective pilot study, foregut SB specimens from three sites (4 per site per patient per processing technique) were allocated to CB or histology, and assessed by a single, blinded pathologist. The gold standard comprised two standard forceps (CFB) histological specimens per site per patient. Specimen ease of processing, size and number, adequacy for diagnosis and artefact were evaluated. In phase two, CB was used for consecutive patients with indeterminate biliary lesions, and compared with phase one CB results. >Results  In phase one, 240 SB foregut biopsies were performed in 10 patients, 227 specimens recorded by pathologist. Specimen origin was identified in 100 % and 97 % of histology and CB batches respectively. Specimens were significantly larger in the histology group (2.02 mm vs 1.49 mm, P  < 0.05). There was a trend to less crush artifact with CB, and no difference in processing difficulty. In phase two, 11 patients (63.0 ±12.7 years, 91 % female) underwent SpyGlass (SG) assessment of suspected indeterminate stricture (n = 8) or mass (n = 3), and six underwent SB. All CB specimens were adequate for diagnosis. Specimen parameters were not significantly different from luminal CB outcomes. >Conclusions  In this pilot study, cell block cytology showed similar results as histological analysis of SpyBite specimens in the analysis of biliary stricture.
机译：>背景和研究目的不确定的胆道病变的诊断敏感性仍然欠佳。细胞学技术可以减轻小胆管镜标本的障碍。我们的主要目的是比较前肠SpyBite（SB）标本的细胞块细胞学（CB）与标准组织学。我们的次要目的是评估胆汁SB活检中的CB。 >患者和方法这是一个分为两个阶段的前瞻性试验研究。在第一阶段的一项前瞻性先导研究中，将来自三个部位的前肠SB标本（每位患者每个处理技术每个部位4个）分配给CB或组织学，并由一名盲人病理学家进行评估。金标准包括每位患者每个部位两个标准镊子（CFB）组织学标本。评估了样品的易加工性，大小和数量，诊断和假象的适当性。在第二阶段，CB用于连续的不确定性胆道病变患者，并与第一阶段的CB结果进行比较。 >结果在第一阶段，对10例患者进行了240 SB前肠活检，病理学家记录了227个标本。标本的来源分别在100％和97％的组织学和CB批次中被确定。组织学组的标本明显更大（2.02 mm比1.49 mm，P <0.05）。趋势是使用CB压碎工件的可能性降低，并且加工难度没有差异。在第二阶段中，对11例患者（63.0±12.7岁，女性为91％）进行了SpyGlass（SG）评估，怀疑是不确定的狭窄（n = 8）或肿块（n = 3），另有6例接受了SB。所有CB标本均足以诊断。样本参数与管腔CB结果无显着差异。 >结论在这项初步研究中，细胞块细胞学检查与胆道狭窄分析中SpyBite标本的组织学分析结果相似。

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