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Evaluating the Minimal Specimens From Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Pancreatic Masses.

ABSTRACT: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has become one of the most useful diagnostic modalities for the diagnosis of pancreatic mass. The aim of this study was to investigate the role of analyzing the minimal specimens obtained by EUS-FNA for the diagnosis of solid masses of pancreas.This study consisted of retrospective and prospective analyses. The retrospective study was performed on 116 patients who underwent EUS-FNA of solid masses for cytological smear, histological analysis, and combined analysis including immunohistochemical (IHC) staining. In the prospective study, 79 patients were enrolled to evaluate the quality and accuracy of EUS-FNA histological analysis and feasibility of IHC staining.The final diagnoses of all patients included pancreatic cancer (n?=?126), nonpancreatic cancer (n?=?21), other neoplasm (n?=?27), and benign lesions (n?=?21). In our retrospective study, the combined analysis was more sensitive than cytological analysis alone (P?

SUBMITTER: Park JK

PROVIDER: S-EPMC4902361 | biostudies-other | 2016 May

REPOSITORIES: biostudies-other

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Evaluating the Minimal Specimens From Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Pancreatic Masses.

Park Joo Kyung JK Kang Ki Joo KJ Oh Cho Rong CR Lee Jong Kyun JK Lee Kyu Taek KT Jang Kee Taek KT Park Sang-Mo SM Lee Kwang Hyuck KH

Medicine 20160501 21

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has become one of the most useful diagnostic modalities for the diagnosis of pancreatic mass. The aim of this study was to investigate the role of analyzing the minimal specimens obtained by EUS-FNA for the diagnosis of solid masses of pancreas.This study consisted of retrospective and prospective analyses. The retrospective study was performed on 116 patients who underwent EUS-FNA of solid masses for cytological smear, histological a ...[more]

PMID: 27227937

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Project description:ObjectiveTo evaluate the feasibility and diagnostic performance of ultrasound (US)-guided fine-needle aspiration cytology and core-needle biopsy (US-FNAC/CNB) for the diagnosis of laryngo-hypopharyngeal masses.Materials and methodsThis was a single-center prospective case series. From January 2018 to June 2019, we initially enrolled 40 patients with highly suspicious laryngo-hypopharyngeal masses on laryngoscopic examinations. Of these, 28 patients with the mass involving or abutting the pre-epiglottic, paraglottic, pyriform sinus, and/or subglottic regions were finally included. These patients underwent US examinations with/without subsequent US-FNAC/CNB under local anesthesia for evaluation of the laryngo-hypopharyngeal mass.ResultsOf the 28 patients who underwent US examinations, a laryngo-hypopharyngeal mass was identified in 26 patients (92.9%). US-FNAC/CNB was performed successfully in 25 of these patients (96.2%), while the procedure failed to target the mass in 1 patient (3.8%). The performance of US caused minor subclinical hematoma in 2 patients (7.7%), but no major complications occurred. US-FNAC/CNB yielded conclusive results in 24 (96.0%) out of the 25 patients with a successful procedure, including 23 patients with squamous cell carcinoma (SCC) and 1 patient with a benign mass. In one patient with atypical cells in US-FNAC, additional direct laryngoscopic biopsy (DLB) was required to confirm SCC. Among the 26 patients who received US-FNAC/CNB, the time from first visit to pathological diagnosis was 7.8 days. For 24 patients finally diagnosed with SCC, the time from first visit to the initiation of treatment was 25.2 days. The mean costs associated with US-FNAC/CNB was $272 under the Korean National Health Insurance Service System.ConclusionUS-FNAC/CNB for a laryngo-hypopharyngeal mass is technically feasible in selected patients, providing good diagnostic performance. This technique could be used as a first-line diagnostic modality by adopting appropriate indications to avoid general anesthesia and DLB-related complications.

Project description:Background and study aims ?Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is traditionally considered a first-line strategy for diagnosing pancreatic lesions; however, given less than ideal accuracy rates, fine-needle biopsy (FNB) has been recently developed to yield histological tissue. The aim of this study was to compare diagnostic yield and safety between EUS-FNA and EUS-FNB in sampling of pancreatic masses. Patients and methods ?This was a multicenter retrospective study to evaluate efficacy and safety of EUS-FNA and EUS-FNB for pancreatic lesions. Baseline characteristics including sensitivity, specificity, and accuracy, were evaluated. Rapid on-site evaluation (ROSE) diagnostic adequacy, cell-block accuracy, and adverse events were analyzed. Subgroup analyses comparing FNA versus FNB route of tissue acquisition and comparison between methods with or without ROSE were performed. Multivariable logistic regression was also performed. Results ?A total of 574 patients (n?=?194 FNA, n?=?380 FNB) were included. Overall sensitivity, specificity, and accuracy of FNB versus FNA were similar [(89.09?% versus 85.62?%; P ?=?0.229), (98.04?% versus 96.88?%; P ?=?0.387), and 90.29?% versus 87.50?%; P ?=?0.307)]. Number of passes for ROSE adequacy and cell-block accuracy were comparable for FNA versus FNB [(3.06?±?1.62 versus 3.04?±?1.88; P ?=?0.11) and (3.08?±?1.63 versus 3.35?±?2.02; P ?=?0.137)]. FNA?+?ROSE was superior to FNA alone regarding sensitivity and accuracy [91.96?% versus 70.83?%; P ?<?0.001) and (91.80?% versus 80.28?%; P ?=?0.020)]. Sensitivity of FNB?+?ROSE and FNB alone were superior to FNA alone [(92.17?% versus 70.83?%; P ?<?0.001) and (87.44?% versus 70.83?%; P ?<?0.001)]. There was no difference in sensitivity though improved accuracy between FNA?+?ROSE versus FNB alone [(91.96?% versus 87.44?%; P ?=?0.193) and (91.80?% versus 80.72?%; P ?=?0.006)]. FNB?+?ROSE was more accurate than FNA?+?ROSE (93.13?% versus 91.80?% ; P ?=?0.001). Multivariate analysis showed ROSE was a significant predictor of accuracy [OR 2.60 (95?% CI, 1.41-4.79)]. One adverse event occurred after FNB resulting in patient death. Conclusion ?EUS-FNB allowed for more consistent cell-block evaluation as compared to EUS-FNA. EUS-FNA?+?ROSE was found to have a similar sensitivity to EUS-FNB alone suggesting a reduced need for ROSE as part of the standard algorithm of pancreatic sampling. While FNB alone produced similar diagnostic findings to EUS-FNA?+?ROSE, FNB?+?ROSE still was noted to increase diagnostic yield. This finding may favor a unique role for FNB?+?ROSE, suggesting it may be useful in cases when previous EUS-guided sampling may have been indeterminate.

Dataset Information

Evaluating the Minimal Specimens From Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Pancreatic Masses.

Publications

Evaluating the Minimal Specimens From Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Pancreatic Masses.

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