Background The diagnostic performance of endoscopic retrograde cholangiopancreatography brush cytology for malignant strictures is modest. A novel larger more abrasive brush may have improved diagnostic performance. We compared the utility of the new biliary brush with a conventional brush. Methods The new brush was used in 51 consecutive patients (group 1) referred with a biliary stricture and matched to 102 patients who underwent sampling with a conventional brush (group 2). Demographic data, stricture characteristics, sensitivity, specificity, negative predictive values and positive predictive values were analysed and compared with final diagnosis. Analysis was performed using strict criteria (definite for cancer) and relaxed criteria (suspicious for cancer). All patients had a minimum follow-up of 12 months. Results There was no statistically significant difference in the age and sex distribution between the two groups. Malignancy was diagnosed in 74% in both groups. There was no significant difference in sensitivity between the groups using either strict criteria (sensitivity group 1 47.4% vs group 2 52%, p=0.69) or relaxed criteria (sensitivity group 1 71.1% vs group 2 71.2%, p=1.0). Conclusions Our data suggest that the novel brush design does not confer improved diagnostic performance in malignant biliary strictures when compared in a robust manner. This highlights the difficulties of intraductal brush sampling and the need to develop newer diagnostic techniques. Data are available upon reasonable request.

中文翻译：

---

两种导管内胆管刷细胞学装置对疑似恶性胆管狭窄的连续比较


背景 内镜逆行胰胆管造影刷细胞学对恶性狭窄的诊断性能有限。一种新型的、更大、更具研磨性的刷子可能会提高诊断性能。我们将新型胆刷与传统刷的实用性进行了比较。方法 新刷子在 51 名连续患有胆道狭窄的患者（第 1 组）中使用，并与 102 名使用传统刷子接受采样的患者（第 2 组）相匹配。分析人口统计学数据、狭窄特征、敏感性、特异性、阴性预测值和阳性预测值，并与最终诊断进行比较。使用严格标准（明确癌症）和宽松标准（可疑癌症）进行分析。所有患者均接受了至少 12 个月的随访。结果 两组年龄、性别分布无统计学差异。两组中 74% 的人被诊断为恶性肿瘤。使用严格标准（敏感性第 1 组 47.4% vs 第 2 组 52%，p=0.69）或宽松标准（敏感性第 1 组 71.1% vs 第 2 组 71.2%，p=1.0）的各组之间的敏感性没有显着差异。结论 我们的数据表明，以稳健的方式进行比较时，新型刷子设计并不能改善恶性胆道狭窄的诊断性能。这凸显了导管内刷采样的困难以及开发更新的诊断技术的必要性。数据可根据合理要求提供。