Scope position is a determining factor for diagnostic performance of endoscopic ultrasound-guided fine-needle aspiration for mass lesions in the pancreatic head
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Background: This study aimed to identify the clinical and endoscopic factors that determined the diagnostic performance of endoscopic ultrasoundguided fine-needle aspiration (EUS-FNA) for mass lesions in the pancreatic head. Methods: A total of 78 consecutive patients with suspected mass lesions in the pancreatic head detected by contrast-enhanced multi-detector-row computed tomography and/or magnetic resonance imaging, who underwent EUS-FNA for cytologic and/or histologic confirmation in our institution between June 2012 and April 2017 were enrolled in the current study. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of EUS-FNA for mass lesions in the pancreatic head in our series was 61/69 (88.4%), 9/9 (100.0%), 61/61 (100.0%), 9/17 (52.9%), and 70/78 (89.7%), respectively. In univariate analyses, the clinical and endoscopic factors for determining the diagnostic performance of EUS-FNA were the echoendoscope position during needle puncture (long vs. short scope position) and the distance from the echoendoscope to the mass lesion (< 1 cm vs. ≥ 1 cm). In the multivariate logistic regression analysis, the echoendoscope position during needle puncture was the only independent and significant determining factor for the diagnostic performance of EUS-FNA for mass lesions in the pancreatic head. Conclusion: The echoendoscope position during needle puncture is a determining factor for the diagnostic performance of EUS-FNA for mass lesions in the pancreatic head.
Abstract
Background: This study aimed to identify the clinical and endoscopic factors that determined the diagnostic performance of endoscopic ultrasoundguided fine-needle aspiration (EUS-FNA) for mass lesions in the pancreatic head. Methods: A total of 78 consecutive patients with suspected mass lesions in the pancreatic head detected by contrast-enhanced multi-detector-row computed tomography and/or magnetic resonance imaging, who underwent EUS-FNA for cytologic and/or histologic confirmation in our institution between June 2012 and April 2017 were enrolled in the current study. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of EUS-FNA for mass lesions in the pancreatic head in our series was 61/69 (88.4%), 9/9 (100.0%), 61/61 (100.0%), 9/17 (52.9%), and 70/78 (89.7%), respectively. In univariate analyses, the clinical and endoscopic factors for determining the diagnostic performance of EUS-FNA were the echoendoscope position during needle puncture (long vs. short scope position) and the distance from the echoendoscope to the mass lesion (< 1 cm vs. ≥ 1 cm). In the multivariate logistic regression analysis, the echoendoscope position during needle puncture was the only independent and significant determining factor for the diagnostic performance of EUS-FNA for mass lesions in the pancreatic head. Conclusion: The echoendoscope position during needle puncture is a determining factor for the diagnostic performance of EUS-FNA for mass lesions in the pancreatic head.
참고문헌 (28)
- Dumonceau JM, "Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology:European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline", Endoscopy, 43, pp.897~912 (2011)
- Voss M, "Value of endoscopic ultrasound guided fine needle aspiration biopsy in the diagnosis of solid pancreatic masses", Gut, 46, pp.244~249 (2000)
- Kim J, "Clinical factors associated with accuracy of EUS-FNA for pancreatic or peripancreatic solid mass without on-site cytopathologists", J Gastroenterol Hepatol, 29, pp.887~892 (2014)
- Uehara H, "Diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration for suspected pancreatic malignancy in relation to the size of lesions", J Gastroenterol Hepatol, 26, pp.1256~1261 (2011)
- Gimeno-García AZ, "How to improve the success of endoscopic ultrasound guided fine needle aspiration cytology in the diagnosis of pancreatic lesions", J Interv Gastroenterol, 2, pp.31~36 (2012)
- Siddiqui AA, "Relationship of pancreatic mass size and diagnostic yield of endoscopic ultrasound-guided fine needle aspiration", Dig Dis Sci, 56, pp.3370~3375 (2011)
- Kim HJ, "Endosonographer's macroscopic evaluation of EUS-FNAB specimens after interactive cytopathologic training : a single-center prospective validation cohort study", Surg Endosc, 30, pp.4184~4192 (2016)
- Hartwig W, "Preoperative tissue diagnosis for tumours of the pancreas", Br J Surg, 96, pp.5~20 (2009)
- Hewitt MJ, "EUSguided FNA for diagnosis of solid pancreatic neoplasms : a meta-analysis", Gastrointest Endosc, 75, pp.319~331 (2012)
- Kalogeraki A, "EUS-fine-needle aspiration biopsy(FNAB)in the diagnosis of pancreatic adenocarcinoma : a review", Rom J Intern Med, 54, pp.24~30 (2016)
- Chang Yun Hwang, "Endoscopic Ultrasound Guided Fine Needle Aspiration Biopsy in Diagnosis of Pancreatic and Peripancreatic Lesions: A Single Center Experience in Korea", Gut and Liver, 3(2), pp.116~121 (2009), 거트앤리버 소화기연관학회협의회
- Hébert-Magee S, "The presence of a cytopathologist increases the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration cytology for pancreatic adenocarcinoma : a meta-analysis", Cytopathology, 24, pp.159~171 (2013)
- Iglesias-Garcia J, "Influence of on-site cytopathology evaluation on the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration(EUS-FNA)of solid pancreatic masses", Am J Gastroenterol, 106, pp.1705~1710 (2011)
- Chang KJ, "Maximizing the yield of EUS-guided fine-needle aspiration", Gastrointest Endosc, 56(4 Suppl), pp.S28~S34 (2002)
- Harewood GC, "Endosonography-guided fine needle aspiration biopsy in the evaluation of pancreatic masses", Am J Gastroenterol, 97, pp.1386~1391 (2002)
- Graham RA, "Fine-needle aspiration biopsy of pancreatic ductal adenocarcinoma : loss of diagnostic accuracy with small tumors", J Surg Oncol, 55, pp.92~94 (1994)
- Prashant Kedia, "Technical Advances in Endoscopic Ultrasound(EUS)-Guided Tissue Acquisition for Pancreatic Cancers: How Can We Get the Best Results with EUS-Guided Fine Needle Aspiration?", Clinical Endoscopy, 46(5), pp.552~562 (2013), 대한소화기내시경학회
- Paquin SC, "Training in endoscopic ultrasound-guided fine needle aspiration", Endosc Ultrasound, 3, pp.12~16 (2014)
- Varadarajulu S, "Best practices in endoscopic ultrasoundguided fine-needle aspiration", Clin Gastroenterol Hepatol, 10, pp.697~703 (2012)
- Sakamoto H, "Prospective comparative study of the EUS guided 25-gauge FNA needle with the 19-gauge Trucut needle and 22-gauge FNA needle in patients with solid pancreatic masses", J Gastroenterol Hepatol, 24, pp.384~390 (2009)
- Camellini L, "A randomized clinical trial comparing 22G and 25G needles in endoscopic ultrasoundguided fine-needle aspiration of solid lesions", Endoscopy, 43, pp.709~715 (2011)
- Fabbri C, "Endoscopic ultrasound-guided fine needle aspiration with 22-and 25-gauge needles in solid pancreatic masses : a prospective comparative study with randomisation of needle sequence", Dig Liver Dis, 43, pp.647~652 (2011)
- Mortenson MM, "Current diagnosis and management of unusual pancreatic tumors", Am J Surg, 196, pp.100~113 (2008)
- Kim JJ, "Lower yield of endoscopic ultrasound-guided fine-needle aspiration in patients with pancreatic head mass with a biliary stent", Dig Dis Sci, 60, pp.543~549 (2015)
- Pancreatric Section, British Society of Gastroenterology, "Guidelines for the management of patients with pancreatic cancer periampullary and ampullary carcinomas", Gut, 54(Suppl 5), pp.v1~v16 (2005)
- Greenblatt DY, "Preoperative factors predict perioperative morbidity and mortality after pancreaticoduodenectomy", Ann Surg Oncol, 18, pp.2126~2135 (2011)
- Reicher S, "Fluorescence in situ hybridization and K-ras analyses improve diagnostic yield of endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic masses", Pancreas, 40, pp.1057~1062 (2011)
- Matsubayashi H, "Pathological and molecular aspects to improve endoscopic ultrasonography-guided fineneedle aspiration from solid pancreatic lesions", Pancreas, 47, pp.163~172 (2018)