Factors affecting the accuracy of endoscopic ultrasound-guided fine needle aspiration for the diagnosis of small (≤20 mm) pancreatic lesions.

Published on Jul 1, 2020in Journal of Digestive Diseases2.325
· DOI :10.1111/1751-2980.12875
Hong Zhen Li1
Estimated H-index: 1
(NU: Nanjing University),
Chun Yan Peng2
Estimated H-index: 2
(NU: Nanjing University)
+ 7 AuthorsYing Lv16
Estimated H-index: 16
(NU: Nanjing University)
Sources
Abstract
AIMS: The main objective was to explore the diagnostic value of Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for small solid pancreatic lesions (≤20 mm) and factors affecting the accuracy in these patients. METHODS: 92 patients with small pancreatic lesions who underwent EUS-FNA at the Nanjing Drum Tower Hospital from November 2009 to January 2019 were retrospectively analyzed. Univariate and multivariate were used to analyze the factors affecting the accuracy of EUS-FNA for these lesions. RESULTS: Among the 92 patients, 56 (60.9%) cases were malignant and 36 (39.1%) were benign. The cytology and the histology were determined adequate in 92(100 %) and 76(86.0%) cases. The sensitivity, specificity and accuracy of EUS-FNA for the diagnosis of small pancreatic solid lesions were 69.20%, 100% and 82.6%, respectively. When considering the impact of the presence of a tissue core on the diagnosis, the sensitivity, specificity, and accuracy of EUS-FNA with histology versus those without histology (cytology alone) were 77.3% versus 50%; 100% versus 100%; 76.2% versus 40%, respectively. Multivariate analysis demonstrated that smaller tumor size (OR = 4.200, 95% CI: 1.21-14.53, p = 0.023) and lack of histological diagnosis (OR = 4.593, 95% CI: 1.03-20.47, p = 0.046) significantly reduce puncture accuracy. CONCLUSIONS: Our results suggest that EUS-FNA is effective and safe for the diagnosis of small pancreatic lesions. Tumor size and presence of macroscopic visible tissue core is related to the accuracy of EUS-FNA.
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#1Spencer Cheng (USP: University of São Paulo)H-Index: 10
#2Vitor Ottoboni Brunaldi (USP: University of São Paulo)H-Index: 13
Last. E. L. A. Artifon (USP: University of São Paulo)H-Index: 5
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Abstract Background Suction (S) is commonly used to improve cell acquisition during endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Slow-pull (SP) sampling is another technique that might procure good quality specimens with less bloodiness. We aimed to determine if SP improves the diagnostic yield of EUS-FNA of pancreatic masses. Methods Patients with pancreatic solid masses were randomized to four needle passes with both techniques in an alternate fashion. Sensitivity, specificit...
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#1Diane Lorenzo (Paris Diderot University)H-Index: 1
#2Vinciane Rebours (Paris Diderot University)H-Index: 40
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: Managing familial pancreatic cancer (FPC) is challenging for gastroenterologists, surgeons and oncologists. High-risk individuals (HRI) for pancreatic cancer (PC) (FPC or with germline mutations) are a heterogeneous group of subjects with a theoretical lifetime cumulative risk of PC over 5%. Screening is mainly based on annual magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS). The goal of screening is to identify early-stage operable cancers or high-risk precancerous lesions (pa...
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Detection of small pancreatic cancers, which have a better prognosis than large cancers, is needed to reduce high mortality rates. Endoscopic ultrasound (EUS) is the most sensitive imaging modality for detecting pancreatic lesions. The high resolution of EUS makes it particularly useful for detecting small pancreatic lesions that may be missed by other imaging modalities. Therefore, EUS should be performed in patients with obstructive jaundice in whom computed tomography (CT) or magnetic resonan...
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Objectives: to determine the diagnostic yield of endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) for suspected pancreatic malignancy. As well as to identify factors that affect the incidence of false-negative cases and evaluate the value of repeated EUS-FNA in patients with inconclusive results. Methods: we retrospectively evaluated the data of patients who underwent EUS-FNA due to a suspected pancreatic malignancy in our hospital from January 2015 to December 2016. Results: a...
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#1Payal Saxena (Johns Hopkins University)H-Index: 19
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Background and study aim Standard endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) procedures involve use of no-suction or suction aspiration techniques. A new aspiration method, the stylet slow-pull technique, involves slow withdrawal of the needle stylet to create minimum negative pressure. The aim of this study was to compare the sensitivity of EUS-FNA using stylet slow-pull or suction techniques for malignant solid pancreatic lesions using a standard 22-gauge needle. Patients an...
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Background and Aims. Endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) is the method of choice for sampling pancreatic lesions. This study compares the diagnostic accuracy and safety of FNB using a novel core needle to FNA in solid pancreatic lesions. Methods. A retrospective review of patients in whom EUS FNA or FNB was performed for solid pancreatic lesions was conducted. Diagnostic performance was calculated based upon a dual classification system: classification 1, only maligna...
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Background/Aims: This study analyzed the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for pancreatic solid masses in patients with or without chronic pancreatitis as well as the clinical parameters relevant to a malignancy when EUS-FNA was negative or inconclusive. Methods: A total of 97 patients, who underwent EUS-FNA for solid pancreatic masses over 2 years at a single institution, were evaluated. All patients underwent EUS-FNA for 3-5 passes with 22 or ...
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Last. Armando Gabbrielli (University of Verona)H-Index: 29
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Abstract Background Early detection of small solid pancreatic lesions is increasingly common. To date, few and contradictory data have been published about the relationship between lesion size and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) diagnostic yield. The aim of this study was to assess the relation between the size of solid pancreatic lesions and the diagnostic yield of EUS-FNA using a 25-gauge needle in a center without available rapid on-site evaluation. Methods In th...
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Advanced pancreatic cancer (PC) is an aggressive malignancy with few effective therapeutic options. While the evolution of precision medicine in recent decades has changed the treatment landscape in many cancers, at present no targeted therapies are used in the routine management of PC. Only a minority of patients with PC present with surgically resectable disease, and in the remainder obtaining high quality biopsy material for both diagnosis and molecular testing can prove challenging. Endoscop...
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Background and aim Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is commonly used to obtain tissue external to the gastrointestinal tract. EUS-FNA is relatively safe, but occasionally adverse events have been reported. There is scarcity of data on risk factors of adverse events. The aim of this study is to identify risk factors associated with EUS-FNA. Methods In this multicenter case-control study, we retrospectively reviewed 4,097 cases between 2009 and 2012 at 15 hospitals in ...
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Background Endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) is important for the differential diagnosis of solid pancreatic lesions. Sample adequacy is related to the number of needle passes, and European guidelines recommend three to four needle passes with a standard EUS-FNA needle. We aimed to evaluate the optimal number of passes with standard EUS-FNA needles in solid pancreatic lesions. Methods Patients with solid pancreatic masses without cystic component >20% on computed...
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