Risk factors for biliary malignancy in indeterminate biliary stricture with atypical cells on endoscopic retrograde brush cytology

Abstract

Objective To identify the risk factors predicting biliary malignancy in indeterminate biliary strictures with atypical cells on endoscopic retrograde brush cytology(ERBC). Methods From January 2008 to December 2013, 121 patients with indeterminate biliary strictures and atypical cells on ERBC were included. Data of age, gender, the location and length of biliary stricture, follow-up outcomes and experimental results were collected and logistic analysis was performed. Results A total of 73 in 121(60.3%)patients were diagnosed as having a malignant stricture, 66 by pathological diagnosis and 7 by disease progress and imaging. Logistic regression analysis showed that age(OR=1.198, 95%CI: 1.040-1.381), the length of the stricture(OR=7.065, 95%CI: 1.558-32.041), the level of CA 19-9(OR=1.023, 95%CI: 1.006-1.040)and primary sclerosing cholangitis were the risk factors of biliary malignancy. Conclusion Patient older than 51.5 years old, the length of the stricture larger than 1.75 cm, the level of CA 19-9 higher than 122.05 U/ml are the risk factors for biliary malignancy in the patients with indeterminate biliary stricture and atypical cells on ERBC. Key words: Risk factors; Indeterminate biliary strictures; Endoscopic retrograde brush cytology; Atypical cells