Slow-pull and different conventional suction techniques in endoscopic ultrasound-guided fine-needle aspiration of pancreatic solid lesions using 22-gauge needles.

Autor:	Chen JY; Jia-Ying Chen, Qing-Yu Ding, Wen Guo, Fa-Chao Zhi, Si-De Liu, Tian-Ming Cheng, Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China., Ding QY; Jia-Ying Chen, Qing-Yu Ding, Wen Guo, Fa-Chao Zhi, Si-De Liu, Tian-Ming Cheng, Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China., Lv Y; Jia-Ying Chen, Qing-Yu Ding, Wen Guo, Fa-Chao Zhi, Si-De Liu, Tian-Ming Cheng, Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China., Guo W; Jia-Ying Chen, Qing-Yu Ding, Wen Guo, Fa-Chao Zhi, Si-De Liu, Tian-Ming Cheng, Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China., Zhi FC; Jia-Ying Chen, Qing-Yu Ding, Wen Guo, Fa-Chao Zhi, Si-De Liu, Tian-Ming Cheng, Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China., Liu SD; Jia-Ying Chen, Qing-Yu Ding, Wen Guo, Fa-Chao Zhi, Si-De Liu, Tian-Ming Cheng, Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China., Cheng TM; Jia-Ying Chen, Qing-Yu Ding, Wen Guo, Fa-Chao Zhi, Si-De Liu, Tian-Ming Cheng, Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
Jazyk:	angličtina
Zdroj:	World journal of gastroenterology [World J Gastroenterol] 2016 Oct 21; Vol. 22 (39), pp. 8790-8797.
DOI:	10.3748/wjg.v22.i39.8790
Abstrakt:	Aim: To evaluate the cytological diagnostic capacity and sample quality of the slow-pull technique and compare them with different suction techniques. Methods: From July 2010 to December 2015, 102 patients with pancreatic solid lesions who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with 22-gauge needles were retrospectively evaluated. EUS-FNA diagnosis was based on a cytological examination, and final diagnosis was based on a comprehensive standard of cytological diagnosis, surgical pathology and clinical or imaging follow-up. Cytological specimens were characterized for cellularity and blood contamination. The cytological diagnostic capacity and sample quality of the slow-pull technique and suction techniques with 5-mL/10-mL/20-mL syringes were analyzed. Results: Of all of the EUS-FNA procedures, the slow-pull technique and suction techniques with 5-mL/10-mL/20-mL syringes were used in 31, 19, 34 and 18 procedures, respectively. There were significant differences between these four suction techniques in terms of cytological diagnostic accuracy (90.3% vs 63.2% vs 58.8% vs 55.6%, P = 0.019), sensitivity (88.2% vs 41.7% vs 40.0% vs 36.4%, P = 0.009) and blood contamination (score ≥ 2 for 29.0% vs 52.6% vs 70.6% vs 72.2%, P = 0.003). The accuracy and sensitivity of the slow-pull technique were significantly higher than those of the suction techniques using 5-mL ( P = 0.03, P = 0.014), 10-mL ( P = 0.005; P = 0.006) and 20-mL syringes ( P = 0.01, P = 0.01). Blood contamination was significantly lower in the slow-pull technique than in the suction techniques with 10-mL ( P = 0.001) and 20-mL syringes ( P = 0.007). Conclusion: The slow-pull technique may increase the cytological diagnostic accuracy and sensitivity with slight blood contamination during EUS-FNA when using 22-gauge needles for solid pancreatic masses. Competing Interests: Conflict-of-interest statement: Each author certifies that he or she has no commercial associations that might pose a conflict of interest in connection with the submitted article.
Databáze:	MEDLINE
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