Accuracy of endoscopic ultrasound-guided tissue acquisition in the evaluation of lymph nodes enlargement in the absence of on-site pathologist
| Autor: | Ihab Abdulkader-Nallib, Jose Lariño-Noia, Daniel de la Iglesia, J. Enrique Domínguez-Muñoz, Julio Iglesias-Garcia, Yung Ka Chin, Hector Lázare, Susana Rebolledo Olmedo |
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| Rok vydání: | 2017 |
| Předmět: |
Endoscopic ultrasound
Male Pathology medicine.medical_specialty Lymphoma Sensitivity and Specificity Fine needle biopsy 03 medical and health sciences 0302 clinical medicine Fine-needle biopsy Predictive Value of Tests Retrospective Study medicine Humans Prospective Studies Lymph node Endoscopic Ultrasound-Guided Fine Needle Aspiration Accuracy Aged Retrospective Studies Fine-needle aspiration medicine.diagnostic_test business.industry Gastroenterology Mediastinum General Medicine Middle Aged Lymph nodes enlargement Tissue acquisition medicine.anatomical_structure 030220 oncology & carcinogenesis Lymphatic Metastasis Feasibility Studies 030211 gastroenterology & hepatology Female Radiology Lymph Nodes business |
| Zdroj: | World Journal of Gastroenterology |
| ISSN: | 2219-2840 |
| Popis: | AIM To evaluate factors that influence the diagnostic accuracy of endoscopic ultrasound (EUS)-guided tissue acquisition for lymph node enlargement in the absence of an on-site pathologist. METHODS A retrospective analysis of patients who underwent EUS-guided tissue acquisition for the pathological diagnosis of lymph node enlargement between April 2012 and June 2015 is reported. Tissue acquisition was performed with both cytology and biopsy needles of different calibers. The variables evaluated were lymph node location and size, number of passes and type of needle used. Final diagnosis was based on surgical histopathology or, in non-operated cases, on EUS-guided tissue acquisition and imaging assessment with a minimum clinical follow-up of 6 mo. RESULTS During the study period, 168 lymph nodes with a median size of 20.3 mm (range 12.5-27) were sampled from 152 patients. Ninety lymph nodes (53.6%) were located at mediastinum, and 105 (62.5%) were acquired with biopsy needles. The final diagnosis was benign/reactive origin in 87 cases (51.8%), malignant in 65 cases (38.7%), and lymphoma in 16 cases (9.5%). The sensitivity, specificity, positive predictive value and negative predictive value for the detection of malignancy were 74.1%, 100%, 100% and 80.6%, respectively. The overall accuracy was 87.5% (95%CI: 81.7-91.7). No variables were independently associated with a correct final diagnosis according to the multivariate analysis. CONCLUSION EUS-guided tissue acquisition is a highly accurate technique for assessing lymph node enlargement. None of the variables evaluated were associated with diagnostic accuracy. |
| Databáze: | OpenAIRE |
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