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Register a new userDiagnostic Value of Cytology in the Evaluation of the Biliary Tree Strictures
القيمة التشخيصية للدراسة الخلوية (Cytology) في دراسة تضيقات الشجرة الصفراوية
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أُجري هذا البحث لدراسة دور الدراسة الخلوية (cytology) بالفرشاة في تحديد سبب التضيق ضمن الشجرة الصفراوية . حيث أنّ الفرشاة تُعتبر تقنيةً ذاتَ قيمةٍ كبيرةٍ لتوفير العينات الخلوية أثناء إجراء تصوير الطرق الصفراوية و المعثكلية التنظيري بالطريق الراجع (ERCP) لمرضى التضيق الصفراوي . شملت الدراسة 34 مريضاً مع تضيق صفراوي , و تم إجراء ERCP لجميع المرضى و أخذت عينات للدراسة الخلوية باستخدام الفرشاة . و خلال مدة الدراسة التي بلغت عاماً , تم وضع التشخيص النهائي لجميع هؤلاء المرضى بمقاربة منهجية (سريرية , شعاعية , مخبرية , نسيجية بخزعات جراحية ) . و دُرست حساسية و نوعية الفرشاة لتشخيص التضيق الخبيث و بلغت حساسيتها 57.1% , نوعية 100% , قيمة تنبؤية إيجابية 100% , قيمة تنبؤية سلبية 76.9 % , و دقة تشخيصية 82%. النتيجة : إن الدراسة الخلوية بالفرشاة تملك نوعيةً عاليةً جداً و لكن حساسيةً متوسطة لتشخيص التضيق الخبيث و مع ذلك فيهي ذات فائدةٍ تشخيصيةٍ عاليةٍ للتمييز بين الأسباب الخبيثة و الحميدة للتضيق الصفراوي .
This research is designed to study the diagnostic yield of brush cytology for biliary strictures. Brush cytology technique is of a great value to provide cytological samples during ERCP for patients with biliary strictures . The study included 34 patients with biliary stricture, ERCP was performed to all patients and cellular samples were taken using a brush for cytology . During the study period (one year) , the final diagnosis was made using a systematic approach based on clinical, radiological, laboratory or histopathological diagnosis . Sensitivity and specificity of brush cytology were studied . The sensitivity of biliary brushing was 57.1% , specificity was 100%, positive predictive value was 100% , negative predictive value was 76.9% and accuracy was 82% . Conclusions: Brush cytology has a very high specificity but an intermediate sensitivity for the diagnosis of malignant biliary strictures . Despite that , brush cytology is of a high diagnostic utility to distinguish between malignant and benign causes of biliary strictures .
Artificial intelligence review:
Research summary
تتناول هذه الدراسة القيمة التشخيصية للدراسة الخلوية باستخدام الفرشاة في تحديد أسباب تضيق الشجرة الصفراوية. تم إجراء البحث على 34 مريضًا يعانون من تضيق صفراوي، حيث تم استخدام تقنية ERCP لأخذ عينات خلوية بواسطة الفرشاة. أظهرت النتائج أن حساسية الفرشاة لتشخيص التضيق الخبيث بلغت 57.1%، بينما كانت النوعية 100%، والقيمة التنبؤية الإيجابية 100%، والقيمة التنبؤية السلبية 76.9%، والدقة التشخيصية 82%. خلصت الدراسة إلى أن الدراسة الخلوية بالفرشاة تمتلك نوعية عالية جدًا ولكن حساسية متوسطة لتشخيص التضيق الخبيث، ومع ذلك فهي ذات فائدة تشخيصية عالية للتمييز بين الأسباب الخبيثة والحميدة للتضيق الصفراوي. أوصت الدراسة باستخدام الفرشاة لجميع التضيقات الصفراوية المصادفة، وإجراء التوسيع قبل أخذ العينات، وتكرار الدراسة الخلوية عند الحاجة.
Critical review
تعتبر هذه الدراسة مهمة جدًا في مجال التشخيص الطبي لأمراض الشجرة الصفراوية، حيث تقدم معلومات قيمة حول فعالية استخدام الفرشاة في الحصول على عينات خلوية. ومع ذلك، يمكن توجيه بعض النقد البناء للدراسة. أولاً، حجم العينة صغير نسبيًا (34 مريضًا) مما قد يؤثر على تعميم النتائج. ثانيًا، لم تتناول الدراسة بشكل كافٍ العوامل التي قد تؤثر على حساسية ونوعية الفرشاة مثل خبرة الأطباء والتقنيات المستخدمة. ثالثًا، كان من الأفضل تضمين مقارنة مع تقنيات تشخيصية أخرى لتحسين فهم الفوائد والقيود لكل تقنية. على الرغم من هذه النقاط، فإن الدراسة تقدم إسهامًا مهمًا في تحسين التشخيص الطبي لأمراض الشجرة الصفراوية.
Questions related to the research
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ما هي الحساسية والنوعية للدراسة الخلوية بالفرشاة في تشخيص التضيق الخبيث؟
حساسية الدراسة الخلوية بالفرشاة في تشخيص التضيق الخبيث بلغت 57.1%، بينما كانت النوعية 100%.
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ما هي الفائدة التشخيصية للدراسة الخلوية بالفرشاة؟
الدراسة الخلوية بالفرشاة تمتلك نوعية عالية جدًا وحساسية متوسطة، مما يجعلها ذات فائدة تشخيصية عالية للتمييز بين الأسباب الخبيثة والحميدة للتضيق الصفراوي.
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ما هي التوصيات التي قدمتها الدراسة؟
أوصت الدراسة باستخدام الفرشاة لجميع التضيقات الصفراوية المصادفة، وإجراء التوسيع قبل أخذ العينات، وتكرار الدراسة الخلوية عند الحاجة.
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ما هي العوامل التي قد تؤثر على حساسية ونوعية الفرشاة؟
العوامل التي قد تؤثر على حساسية ونوعية الفرشاة تشمل خبرة الأطباء، التقنيات المستخدمة، وموقع التضيق في الشجرة الصفراوية.
References used
VECCHIO R, FERRARA M, PUCCI L, MELI G, LATTERI S. [Treatment of iatrogenic lesions of the common bile duct] [Italian]. Minerva Chir. 1995 Jan-Feb. 50(1-2):29-38
HANAU LH, STEIGBIGEL NH. Acute (ascending) cholangitis. Infect Dis Clin North Am. 2000 Sep. 14(3):521-46
HASTIER P, BUCKLEY JM, PETEN EP, DUMAS R, DELMONT J. Long term treatment of biliary stricture due to chronic pancreatitis with a metallic stent. Am J Gastroenterol. 1999 Jul. 94(7):1947-8
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