Repeat endoscopic ultrasound fine needle aspiration after a first negative procedure is useful in pancreatic lesions
| Autor: | Francisco Valdovinos-Andraca, Ambrosio Rafael Bernal-Méndez, Camilo Guerrero-Velásquez, Miguel Ángel Ramírez-Luna, Félix I. Téllez-Ávila, Anamaría Rosales-Salinas, Jorge Adolfo Martínez-Lozano |
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| Rok vydání: | 2016 |
| Předmět: |
Endoscopic ultrasound
medicine.medical_specialty pancreatic cancer Lesion 03 medical and health sciences 0302 clinical medicine Pancreatic cancer medicine Radiology Nuclear Medicine and imaging In patient skin and connective tissue diseases Hepatology medicine.diagnostic_test business.industry fine needle aspiration Gastroenterology Odds ratio medicine.disease digestive system diseases Confidence interval body regions surgical procedures operative Fine-needle aspiration medicine.anatomical_structure 030220 oncology & carcinogenesis Original Article 030211 gastroenterology & hepatology Radiology medicine.symptom Pancreas business |
| Zdroj: | Endoscopic Ultrasound |
| ISSN: | 2303-9027 |
| DOI: | 10.4103/2303-9027.187889 |
| Popis: | Background and objectives There is no consensus about the ideal method for diagnosis in patients who have already undergone endoscopic ultrasound fine needle aspiration (EUS-FNA), and the inconclusive material is often obtained. The aim was to evaluate the diagnostic yield of the second EUS-FNA of pancreatic lesions. Materials and methods A retrospective analysis of prospectively collected data of patients with EUS-FNA of pancreatic lesions is performed. All patients who underwent more than one EUS-FNA for the evaluation of suspected pancreatic cancer over a 7-year period were included in the analysis. Results A total of 296 EUS-FNAs of the pancreas were performed in 257 patients. The diagnostic yield with the first EUS-FNA was 78.6% (202/257). Thirty-nine (13.3%) FNAs were repeated in 34 patients; 17 (50%) patients were women. The mean ± standard deviation (SD) age was 58.8 ± 16.1 years. The location of the lesions in the pancreatic gland, from which the second biopsies were taken, was head of the pancreas, n = 28 (82.4%), body of the pancreas, n = 3 (8.8%), and tail, n = 3 (8.8%). The mean ± SD of the size of the lesion was 36.3 ± 14.6 mm. The second EUS-FNA was more likely to be positive for diagnosis in patients with an "atypical" histological result in the first EUS-FNA (odds ratio [OR]: 4.04; 95% confidence interval [CI]: 0.9-18.3), in contrast to patients with a first EUS-FNA reported as "normal" (OR: 0.21; 95% CI: 0.06-0.71). Overall, the diagnostic yield of the second EUS-FNA was 58.8% (20/34) with an increase to 86.3% overall (222/257). Conclusion Repeat EUS-FNA in pancreatic lesions is necessary in patients with a negative first EUS-FNA because it improves the diagnostic yield. |
| Databáze: | OpenAIRE |
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