BACKGROUND: The option of obtaining tissue samples for histological examinationduring endoscopic ultrasound (EUS) has theoretical and practical advantages over cytology alone. The aim of this study was to evaluate the feasibility, yield, anddiagnostic accuracy of a new EUS 22-G fine-needle biopsy (FNB) device in patientswith solid pancreatic masses in a multicenter, prospective study.METHODS: All consecutive patients who underwent EUS-guided fine-needle biopsy(EUS-FNB) using a newly developed 22-G FNB needle between September 2010 andOctober 2010 were enrolled in the study. The EUS-FNB technique was standardizedamong the participating endoscopists. Only a single needle pass was performed.RESULTS: A total of 61 patients (35 males, mean age 64.2 ± 12.4 years) with solidpancreatic masses with a mean size of 32.4 ± 8.5 mm (range 13-90 mm)participated. EUS-FNB was performed through the duodenum in 35 cases (57.4 %) andwas technically feasible in all but one of the 61 (98.4 %) patients withoutcomplications. Tissue samples for histological examination were obtained from 55 patients (90.2 %) and were deemed adequate in 54 of the cases (88.5 %). Thediagnoses established by EUS-FNB were adenocarcinoma (39 patients),neuroendocrine tumors (5), chronic focal pancreatitis (5), sarcoma (2), lymphoma (1), acinar cellular tumor (1), and pancreatic metastasis from renal cellcarcinoma (1). In an intention-to-treat (ITT) analysis, sensitivity, specificity,positive predictive value, negative predictive value, and accuracy for thehistologic diagnosis of a pancreatic mass were 87.5, 100, 100, 41.7, and 88.5 %, respectively.CONCLUSIONS: EUS-FNB was technically feasible in 98 % of patients with a solidpancreatic mass. A suitable sample for histological evaluation was obtained in88.5 % of the cases after only one single needle pass. The apparently lownegative predictive value is likely to be improved by increasing the number ofneedle passes.
Feasibility and yield of a novel 22-gauge histology EUS needle in patients with pancreatic masses: a multicenter prospective cohort study / Larghi, A; Iglesias-Garcia, J; Poley, Jw; Monges, G; Petrone, Mc; Rindi, G; Abdulkader, I; Arcidiacono, P; Costamagna, G; Biermann, K; Bories, E; Doglioni, C; Dominguez-Muñoz, Je; Hassan, C; Bruno, M; Giovannini, M.. - In: SURGICAL ENDOSCOPY. - ISSN 0930-2794. - 27:(2013), pp. 3733-3738. [10.1007/s00464-013-2957-9]
Feasibility and yield of a novel 22-gauge histology EUS needle in patients with pancreatic masses: a multicenter prospective cohort study
Arcidiacono P;Doglioni C;
2013-01-01
Abstract
BACKGROUND: The option of obtaining tissue samples for histological examinationduring endoscopic ultrasound (EUS) has theoretical and practical advantages over cytology alone. The aim of this study was to evaluate the feasibility, yield, anddiagnostic accuracy of a new EUS 22-G fine-needle biopsy (FNB) device in patientswith solid pancreatic masses in a multicenter, prospective study.METHODS: All consecutive patients who underwent EUS-guided fine-needle biopsy(EUS-FNB) using a newly developed 22-G FNB needle between September 2010 andOctober 2010 were enrolled in the study. The EUS-FNB technique was standardizedamong the participating endoscopists. Only a single needle pass was performed.RESULTS: A total of 61 patients (35 males, mean age 64.2 ± 12.4 years) with solidpancreatic masses with a mean size of 32.4 ± 8.5 mm (range 13-90 mm)participated. EUS-FNB was performed through the duodenum in 35 cases (57.4 %) andwas technically feasible in all but one of the 61 (98.4 %) patients withoutcomplications. Tissue samples for histological examination were obtained from 55 patients (90.2 %) and were deemed adequate in 54 of the cases (88.5 %). Thediagnoses established by EUS-FNB were adenocarcinoma (39 patients),neuroendocrine tumors (5), chronic focal pancreatitis (5), sarcoma (2), lymphoma (1), acinar cellular tumor (1), and pancreatic metastasis from renal cellcarcinoma (1). In an intention-to-treat (ITT) analysis, sensitivity, specificity,positive predictive value, negative predictive value, and accuracy for thehistologic diagnosis of a pancreatic mass were 87.5, 100, 100, 41.7, and 88.5 %, respectively.CONCLUSIONS: EUS-FNB was technically feasible in 98 % of patients with a solidpancreatic mass. A suitable sample for histological evaluation was obtained in88.5 % of the cases after only one single needle pass. The apparently lownegative predictive value is likely to be improved by increasing the number ofneedle passes.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
