Abstract
Objective To explore the diagnostic value of alcohol fixation and liquid-based cytology method for malignant stricture of common bile duct and to study the interval time between sampling and fixa- tion for procedure of alcohol fixation. Methods Data of 82 patients were retrospectively studied, who were suspected of having malignant stricture of common bile duct underwent brushing through endoscopic retro- grade cholangiopancreatography (ERCP), and were confirmed by follow-up for 2 years or pathology after sur- gery from October 2008 to June 2013. These patients were randomly divided into alcohol fixation group ( n = 30), liquid-based cytology group ( n = 28 ) and conventional cytology group ( n = 24). The positive diagnostic rates of brush cytology in each group were compared. The alcohol fixation group were randomly divided into 2- minute group and 5-minute group according to the interval time between sampling and fixation. Positive di- agnostic rates were also compared. Results The positive rates were 73.33% ( alcohol fixation group, 22/30 ), 75.00% ( liquid-based cytology group, 21/28 ) and 20. 83% ( conventional cytology group, 5/24), respectively. The positive rate of conventional cytology group was obviously lower than alcohol fixa- tion group (X2 = 21. 525, P = 0. 000) and liquid-based cytology group (X2 = 22. 208, P = O. 000) with sta- tistical significance. But the positive rate of alcohol fixation group was similar to the liquid-based cytology group (X2 = 0. 683, P = 0. 898 ). In alcohol f'Lxation group, the positive rate of 2-min group (88.24%, 15/17) was significantly higher than the 5-min group (53.85%. 7/13 ) with statistical significance (2 =4. 535, P = 0. 033 ). Conclusion Compared with conventional fixation, alcohol fixation and liquid-based cytology can improve positive diagnostic rate of brushing during ERCP. The alcohol fixation is more simple in procedure and low in cost than liquid-based cytology. The interval time between sampling and fixation should be reduced to no more than 2 minutes. Key words: Malignant stricture of common bile duct; Cytological examination; Alcohol fixation
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