L.M. Tselousova1, R.A. Deryabin1, G.V. Gelikonov2, V.E. Zagaynov1,3, N.M. Kiselev1,3, G.G. Torgomyan1,3
1Nizhny Novgorod Regional Clinical Oncological Dispensary, Nizhniy Novgorod
2Federal Research Center A.V. Gaponov-Grekhov Institute of Applied Physics of the Russian Academy of Sciences, Nizhniy Novgorod
3Privolzhsky Research Medical University, Nizhny Novgorod
Tselousova Lada M. ― doctor of X-ray endovascular methods of diagnosis and treatment of the 2nd oncological department of abdominal oncology and X-ray surgical methods of diagnosis and treatment of the Nizhny Novgorod Regional Clinical Oncological Dispensary
11/1 Delovaya Str., Nizhniy Novgorod, 603163, Russian Federation, tel. +7-915-944-45-04, e-mail: email@example.com, ORCID ID: 0000-0002-6005-2684
Abstract. Cholangiocellular carcinoma is a malignant neoplasm of epithelial cells, with signs of cholangiocyte differentiation, which occurs in one of the sections of the biliary tract and/or in the liver parenchyma and characterized by high mortality.
Cholangiocellular carcinoma is the second most common primary liver tumor after hepatocellular carcinoma, which accounts for 10-15% of all primary liver malignancies. Biopsy is not necessary before surgery, however, a significant proportion of patients are eligible for systemic chemotherapy therapy, which requires histological verification of the tumor. The median survival of patients with palliative treatment of a locally advanced tumor is 13,8-16,7 months, and in the presence of distant metastases ― 7,5-9,3 months, which is one of the reasons for establishing the histological type of tumor as soon as possible for timely treatment. Endobiliary biopsy of tumors of extrahepatic bile ducts has become widespread in world practice. According to most authors, percutaneous transhepatic endobiliary biopsy is one of the optimal verification methods: its specificity rate is 100%. The true positive rate is also high at 88%. However, the sensitivity of the method is in a wide range: from 0 to 94%. In recent years, the method of optical coherence tomography has been actively used for diagnostic purposes in oncology. Using this method to obtained the information about the presumptive nature of pathological changes in the biliary tract increases the sensitivity and specificity of subsequent intraductal biopsy. From August 2021 to March 2023, on the basis of the 2nd oncology department of abdominal oncology and x-ray surgical methods of diagnosis and treatment performed 30 endobiliary biopsy procedures on 24 patients (8 procedures, using optical coherence tomography). The number of verified tumors, according to cytological examination, was 13 samples ― 43,53%. The accuracy of the diagnostic test was 43,53%. Among 8 studies performed with OCT-navigation, the oncological process was cytologically confirmed in 6 patients. Thus, the accuracy of the diagnostic test was 75%.
The accuracy of the endobiliary biopsy diagnostic test, based on histological findings, is 68,97%.
The use of OCT-navigation in the endobiliary biopsy technique made it possible to increase the accuracy of the method to 100%. The use of optical coherence tomography as a navigation method for intraductal biopsy in patients with Klatskin tumor increase the accuracy of diagnosis, reduce the number of biopsy attempts and the period of morphological verification of the tumor and begin antitumor therapy as soon as possible.
Key words: cholangiocellular carcinoma, endobiliary biopsy, optical coherence tomography.