SINGLE-SPECIMEN BILE CYTOLOGY - A PROSPECTIVE-STUDY OF 80 PATIENTS WITH OBSTRUCTIVE-JAUNDICE

PURPOSE: To determine the sensitivity, specificity, and charges associ ated with single-specimen bile cytologic study in patients with obstru ctive jaundice. MATERIALS AND METHODS: Eighty consecutive patients wit h presumed malignant biliary strictures underwent percutaneous biliary drainage (PBD), Cytologic evaluation was performed on a single bile s pecimen from each patient collected at the time of the PBD, Final diag noses were obtained from either percutaneous (n = 14) or surgical (n = 66) histologic specimens (gold standard), Both data sets were then co mpared to determine the sensitivity and specificity of bile cytology. The charges associated with bile cytodiagnosis were compared to those for other biopsy procedures utilized in the same setting. RESULTS: Eig hty bile specimens were obtained with a mean of 14 mt (range, 3-65 mL) per patient with 79 (99%) specimens adequate for cytologic processing , Eleven (13%) specimens were acellular, The overall sensitivity was 1 5% and specificity was 100%; these values were not dependent on the vo lume of the bile specimen (P > .10) or type of malignancy (P = .10), F or bile cytodiagnosis, the mean charge was $160 and the successful bio psy rate (true-positive plus true-negative results/total number proced ures) was 27%, CONCLUSION: Single-specimen bile cytology has a low sen sitivity; however, because of its convenience, Simplicity, atraumatic nature, and low relative charge versus comparable procedures, it may b e useful as an adjunct to PBD in patients with suspected malignant bil iary disease.