Repeated endoscopic ultrasound-guided fine-needle biopsy of solid pancreatic lesions after previous nondiagnostic or inconclusive sampling.

Autor: Lisotti A; Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola, Italy., Cominardi A; Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola, Italy.; Gastroenterology Unit, Hospital of Piacenza, Piacenza, Italy., Conti Bellocchi MC; Digestive Endoscopy Unit, University of Verona, Verona, Italy., Crinò SF; Digestive Endoscopy Unit, University of Verona, Verona, Italy., Larghi A; Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy., Facciorusso A; Gastroenterology Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy., Arcidiacono PG; IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy., De Angelis C; Department of General and Specialist Medicine, Gastroenterologia-U, Città della Salute e della Scienza di Torino, Turin, Italy., Di Matteo FM; Operative Endoscopy Department, Campus Bio-Medico University Hospital, Rome, Italy., Fabbri C; Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Forli, Italy., Bertani H; Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero Universitaria di Modena, Modena, Italy., Togliani T; Gastroenterology and Digestive Endoscopy Unit, University Hospital Borgo Trento, Verona, Italy., Rizzatti G; Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy., Brancaccio M; Unit of Gastroenterology, Santa Maria delle Croci Hospital, AUSL Romagna, Ravenna, Italy., Grillo A; Gastroenterology and Digestive Endoscopy Unit, Rimini 'Infermi' Hospital, AUSL Romagna, Rimini, Italy., Fantin A; Gastroenterology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy., Pezzoli A; Department of Gastroenterology and GI Endoscopy, University Hospital, Ferrara, Italy., D'Errico F; Gastroenterology and Endoscopy Unit, Ente Ecclesiastico F. Miulli, Acquaviva delle Fonti, Bari, Italy., Amato A; Division of Digestive Endoscopy and Gastroenterology, Valduce Hospital, Como, Italy., Antonini F; Gastroenterology and Interventional Endoscopy Unit, 'C. e G. Mazzoni' Hospital, Ascoli Piceno, Italy., Montale A; Division of Gastroenterology, E.O. Galliera Hospital, Genoa, Italy., Pisani A; National Institute of Gastroenterology IRCCS Saverio de Bellis, Castellana Grotte, Bari, Italy., Forti E; Digestive Endoscopy Unit, ASST Niguarda, Milan, Italy., Manno M; Gastroenterology and Digestive Endoscopy Unit, Azienda USL Modena, Modena, Italy., Carrara S; Endoscopic Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy., Petrone MC; IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy., Binda C; Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Forli, Italy., Zagari RM; SSD 'Patologie organiche esofago-gastriche', IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, Bologna, Italy.; Department of Medical and Surgical Sciences - DIMEC, University of Bologna, Bologna, Italy., Fusaroli P; Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola, Italy.
Jazyk: angličtina
Zdroj: Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society [Dig Endosc] 2024 May; Vol. 36 (5), pp. 615-624. Date of Electronic Publication: 2023 Oct 25.
DOI: 10.1111/den.14686
Abstrakt: Objectives: Repeated endoscopic ultrasound (EUS)-guided tissue acquisition represents the standard practice for solid pancreatic lesions after previous nondiagnostic or inconclusive results. Since data are lacking, we aimed to evaluate the diagnostic performance of repeated EUS fine-needle biopsy (rEUS-FNB) in this setting. The primary outcome was diagnostic accuracy; sample adequacy, sensitivity, specificity, and safety were secondary outcomes.
Methods: Consecutive patients undergoing rEUS-FNB for solid pancreatic lesions at 23 Italian centers from 2019 to 2021 were retrieved. Pathology on the surgical specimen, malignant histology together with ≥6-month follow-up, and benign pathology together with ≥12-month follow-up were adopted as gold standards.
Results: Among 462 patients, 56.5% were male, with a median age of 68 (59-75) years, malignancy prevalence 77.0%. Tumor size was 26 (20-35) mm. Second-generation FNB needles were used in 89.6% cases. Diagnostic accuracy, sensitivity, and specificity of rEUS-FNB were 89.2%, 91.4%, and 81.7%, respectively (19 false-negative and 12 false-positive results). On multivariate analysis, rEUS-FNB performed at high-volume centers (odds ratio [OR] 2.12; 95% confidence interval [CI] 1.10-3.17; P = 0.03) and tumor size (OR 1.03; 95% CI 1.00-1.06; P = 0.05) were independently related to diagnostic accuracy. Sample adequacy was 94.2%. Use of second-generation FNB needles (OR 5.42; 95% CI 2.30-12.77; P < 0.001) and tumor size >23 mm (OR 3.04; 95% CI 1.31-7.06; P = 0.009) were independently related to sample adequacy.
Conclusion: Repeated EUS-FNB allowed optimal diagnostic performance after nondiagnostic or inconclusive results. Patients' referral to high-volume centers improved diagnostic accuracy. The use of second-generation FNB needles significantly improved sample adequacy over standard EUS-FNB needles.
(© 2023 The Authors. Digestive Endoscopy published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.)
Databáze: MEDLINE
Externí odkaz: