RESUMEN
Imaging biliary strictures may suggest malignancy, but cytology can provide final diagnosis. In the present evaluation we studied the importance of immunohistochemical analysis of antigen expression in sensitivity and specificity of cytological evaluation of bile duct epithelium cells. Thirty three patients with biliary strictures were examined prospectively. The bile exfoliative cytology during endoscopic retrograde cholangio-pancreatography or surgery was obtained. Bile specimens were routinely stained with hematoxylin-eosin, examined by one experienced cytologist and were reported as positive or negative for malignant cells. In addition, the alterations in immunoperoxidase staining of carcinoembryonic antigen (mab T84,66), mucin (RA 96), cell membrane antigen (17-1A) and c-new were assessed. The results revealed a low sensitivity of both--traditional exfoliative cytology and the immunohistochemical analysis of antigen expression in diagnosis of biliary tract carcinoma (equally 25 and 31%, with the specificity of 92%). Appreciation of the samples with simultaneous involvement of the both studied methods make possible the diagnosis of the bile duct malignant lesions on 7 out of 17 cases (sensitivity 43%) with the specificity of 98%.
Asunto(s)
Antígenos/análisis , Enfermedades de los Conductos Biliares/patología , Ictericia/etiología , Adulto , Anciano , Antígenos de Neoplasias/análisis , Enfermedades de los Conductos Biliares/complicaciones , Neoplasias de los Conductos Biliares/complicaciones , Neoplasias de los Conductos Biliares/patología , Biomarcadores/análisis , Colangiopancreatografia Retrógrada Endoscópica , Diagnóstico Diferencial , Epitelio/patología , Femenino , Humanos , Técnicas para Inmunoenzimas , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Sensibilidad y EspecificidadRESUMEN
Autotransfusion and haemodilution are the most safe and well known methods of blood protection in patients planned for vascular operations. During reconstructive vascular surgery autotransfusion with hypovolemic or normovolemic haemodilution were used. In the I group of patients hypovolemic haemodilution was done. In the II group of patients vascular bed was filed up with Ringer solution or with 6% solution of hydroxyethyl starch. The type of haemodilution and its influence on haemodynamics were estimated. Investigations were done by echocardiograph: ATL ULTRAMARK 8. It was concluded that the most effective are autotransfusion and normovolemic haemodilution with filing up vascular bed with Ringer solution.