Per-Pass Performance Characteristics of Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Malignant Solid Pancreatic Masses in a Large Multicenter Cohort
Autor: | Carrie Marshall, Alireza Sedarat, Rabindra R. Watson, Stephen Kim, Sachin Wani, Phillip S. Ge, Mehdi Mohamadnejad, Srinadh Komanduri, V. Raman Muthusamy, Robert H. Wilson, Jitin Makker |
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Rok vydání: | 2018 |
Předmět: |
Endoscopic ultrasound
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism Cytodiagnosis Malignancy Sensitivity and Specificity Cohort Studies 03 medical and health sciences 0302 clinical medicine Endocrinology Pancreatic cancer Cytology Internal Medicine medicine Pancreatic mass Humans Endoscopic Ultrasound-Guided Fine Needle Aspiration Pancreas Aged Hepatology medicine.diagnostic_test business.industry Reproducibility of Results Middle Aged medicine.disease digestive system diseases Stylet Pancreatic Neoplasms surgical procedures operative Fine-needle aspiration Cytopathology 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Female Radiology business |
Zdroj: | Pancreas. 47(3) |
ISSN: | 1536-4828 |
Popis: | Objectives Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is widely performed for the evaluation of pancreatic masses. We evaluated the performance characteristics of EUS-FNA in obtaining a diagnosis of pancreatic malignancy. Methods We performed a multicenter study of patients who underwent EUS-FNA for a solid pancreatic mass. Endoscopic ultrasound-guided FNA was standardized using a 25-gauge needle, slow-pull stylet technique for specimen acquisition, and on-site cytopathology. For the primary analysis, only malignant cytology was regarded as positive. A secondary analysis was performed in which malignant and/or suspicious cytology was regarded as positive. Results A total of 138 patients underwent EUS-FNA. In the primary analysis, the sensitivity of EUS-FNA for malignancy was 56.7% on first pass, 73.3% on second pass, 83.3% on third pass, 89.2% on fourth pass, and 90.8% on fifth pass, with no increase beyond the fifth pass. In the secondary analysis, the sensitivity was 75.0% on first pass, 89.2% on second pass, 93.3% on third pass, and 95.8% on fourth pass, with no increase beyond the fourth pass. No significant relationship was seen between lesion size and diagnostic yield. Conclusions Using a 25-gauge needle, the maximal diagnostic yield of EUS-FNA for a solid pancreatic mass is reached after 4 needle passes. |
Databáze: | OpenAIRE |
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