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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