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Published in: European Radiology 10/2017

01-10-2017 | Interventional

Percutaneous transluminal forceps biopsy in patients suspected of having malignant biliary obstruction: factors influencing the outcomes of 271 patients

Authors: Jung Gu Park, Gyoo-Sik Jung, Jong Hyouk Yun, Byung Chul Yun, Sang Uk Lee, Byung Hoon Han, Ji Ho Ko

Published in: European Radiology | Issue 10/2017

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Abstract

Objectives

To evaluate predictive factors for false-negative diagnosis of percutaneous forceps biopsies in patients suspected of having a malignant biliary obstruction

Methods

Two hundred seventy one consecutive patients with obstructive jaundice underwent percutaneous forceps biopsy. In each patient, three to five specimens (mean, 3.5 specimens) were collected from the lesion. The final diagnosis for each patient was confirmed with pathologic findings at surgery, additional histocytologic data, or clinical and radiologic follow-up. Univariate and multivariate logistic regression analysis was used to identify risk factors associated with false-negative diagnosis.

Results

One hundred ninety four of 271 biopsies resulted in correct diagnoses of malignancy, while 20 biopsy diagnoses were proved to be true-negative. There were 57 false-negative diagnoses and no false-positive diagnoses. The diagnostic performance of transluminal forceps biopsy in malignant biliary obstructions was as follows: sensitivity, 77.2%; specificity, 100%; and accuracy, 78.9%; positive predictive value, 100%, negative predictive value; 25.9%. Periampullary segment of common bile duct, intrahepatic bile duct and metastatic disease were the significant risk factors of false-negative diagnosis.

Conclusions

Percutaneous forceps biopsy provides relatively high accuracy in the diagnosis of malignant biliary obstructions. The predictive factors of false-negative biopsy were determined to be biopsy site and origin of primary tumour.

Key Points

• Percutaneous forceps biopsy provides relatively high accuracy in diagnosis of malignant biliary obstructions.
• The predictive factors of false-negative biopsy were biopsy site and origin of primary tumour.
• The procedure-related complications were low.
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Metadata
Title
Percutaneous transluminal forceps biopsy in patients suspected of having malignant biliary obstruction: factors influencing the outcomes of 271 patients
Authors
Jung Gu Park
Gyoo-Sik Jung
Jong Hyouk Yun
Byung Chul Yun
Sang Uk Lee
Byung Hoon Han
Ji Ho Ko
Publication date
01-10-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4796-x

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