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Triple-Tissue Sampling during Endoscopic Retrograde Cholangiopancreatography Increases the Overall Diagnostic Sensitivity for Cholangiocarcinoma.
[cholangiocarcinoma]
There
are
several
methods
for
obtaining
tissue
samples
to
diagnose
malignant
biliary
strictures
during
endoscopic
retrograde
cholangiopancreatography
(
ERCP
)
.
However
,
each
method
has
only
limited
sensitivity
.
This
study
aimed
to
evaluate
the
diagnostic
accuracy
of
a
combined
triple-tissue
sampling
(
TTS
)
method
(
on-site
bile
aspiration
cytology
,
brush
cytology
,
and
forceps
biopsy
)
.
We
retrospectively
reviewed
168
patients
with
suspicious
malignant
biliary
strictures
who
underwent
double
-tissue
sampling
(
DTS
;
n
=
121
)
or
TTS
(
n
=
47
)
via
ERCP
at
our
institution
from
2004
to
2011
.
Among
the
168
patients
reviewed
,
117
patients
(
69
.
6
%
)
were
eventually
diagnosed
with
malignancies
.
The
diagnostic
sensitivity
for
cancer
was
significantly
higher
in
the
TTS
group
than
the
DTS
group
(
85
.
0
%
vs
64
.
9
%
,
respectively
;
p
=
0
.
022
)
.
Furthermore
,
the
combination
of
brush
cytology
and
forceps
biopsy
was
superior
to
the
other
method
combinations
in
the
DTS
group
.
With
respect
to
cancer
type
(
cholangiocarcinoma
vs
noncholangiocarcinoma
)
,
interestingly
,
the
diagnostic
sensitivity
was
higher
for
cholangiocarcinoma
in
the
TTS
group
than
the
DTS
group
(
100
%
vs
69
.
4
%
,
respectively
;
p
<
0
.
001
)
but
not
for
the
non-
cholangiocarcinoma
patients
(
57
.
1
%
vs
57
.
1
%
,
respectively
)
.
TTS
can
provide
an
improved
diagnostic
accuracy
in
suspicious
malignant
biliary
strictures
,
particularly
for
cholangiocarcinoma
.
Diseases
Validation
Diseases presenting
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated