Endoscopic Ultrasound Guided Fine Needle Aspiration Biopsy in Diagnosis of Pancreatic and Peripancreatic Lesions: A Single Center Experience in Korea
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초록
Background/Aims: Although endoscopic ultrasound guided fine needle aspiration (EUS-FNA) has been introduced and its use has been increasing in Korea, there have not been many reports about its performance. The aim of this study was to assess the utility of EUS-FNA without on-site cytopathologist in establishing the diagnosis of solid pancreatic and peripancreatic masses from a single institution in Korea. Methods: Medical records of 139 patients who underwent EUS-FNA for pancreatic and peripancreatic solid mass in the year 2007, were retrospectively reviewed. By comparing cytopathologic diagnosis of FNA with final diagnosis, sensitivity, specificity, and accuracy were determined, and factors influencing the accuracy as well as complications were analyzed. Results: One hundred twenty out of 139 cases had final diagnosis of malignancy. Sensitivity, specificity, and accuracy of EUS-FNA were 82%, 89%, and 83%, respectively, and positive and negative predictive values were 100% and 46%, respectively. As for factors influencing the accuracy of FNA, lesion size was marginally significant (p-value 0.08) by multivariate analysis. Conclusions: EUS-FNA performed without on-site cytopathologist was found to be accurate and safe, and thus EUS-FNA should be a part of the standard management algorithm for pancreatic and peripancreatic mass.
Abstract
Background/Aims: Although endoscopic ultrasound guided fine needle aspiration (EUS-FNA) has been introduced and its use has been increasing in Korea, there have not been many reports about its performance. The aim of this study was to assess the utility of EUS-FNA without on-site cytopathologist in establishing the diagnosis of solid pancreatic and peripancreatic masses from a single institution in Korea. Methods: Medical records of 139 patients who underwent EUS-FNA for pancreatic and peripancreatic solid mass in the year 2007, were retrospectively reviewed. By comparing cytopathologic diagnosis of FNA with final diagnosis, sensitivity, specificity, and accuracy were determined, and factors influencing the accuracy as well as complications were analyzed. Results: One hundred twenty out of 139 cases had final diagnosis of malignancy. Sensitivity, specificity, and accuracy of EUS-FNA were 82%, 89%, and 83%, respectively, and positive and negative predictive values were 100% and 46%, respectively. As for factors influencing the accuracy of FNA, lesion size was marginally significant (p-value 0.08) by multivariate analysis. Conclusions: EUS-FNA performed without on-site cytopathologist was found to be accurate and safe, and thus EUS-FNA should be a part of the standard management algorithm for pancreatic and peripancreatic mass.
참고문헌 (19)
- Smith EH, "Complications of percutaneous abdominal fineneedle biopsy. Review", Radiology, 178, pp.253~258 (1991)
- Chang KJ, "Maximizing the yield of EUS-guided fine-needle aspiration", Gastrointest Endosc, 56, pp.S28~S34 (2002)
- Wiersema MJ, "Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment", Gastroenterology, 112, pp.1087~1095 (1997)
- 차재명, "췌장 종괴의 감별 진단에 내시경초음파 유도하 세침흡인생검술의 유용성", 대한소화기내시경학회지, 31(3), pp.147~154 (2005), 대한소화기내시경학회
- Klapman JB, "Clinical impact of on-site cytopathology interpretation on endoscopic ultrasound-guided fine needle aspiration", Am J Gastroenterol, 98, pp.1289~1294 (2003)
- Wittmann J, "Endoscopic ultrasound-guided tissue sampling by combined fine needle aspiration and trucut needle biopsy: a prospective study", Cytopathology, 17, pp.27~33 (2006)
- Eloubeidi MA, "Endoscopic ultrasound- guided fine needle aspiration biopsy of patients with suspected pancreatic cancer: diagnostic accuracy and acute and 30-day complications", Am J Gastroenterol, 98, pp.2663~2668 (2003)
- Harewood GC, "Endosonography-guided fine needle aspiration biopsy in the evaluation of pancreatic masses", Am J Gastroenterol, 97, pp.1386~1391 (2002)
- Volmar KE, "Pancreatic FNA in 1000 cases: a comparison of imaging modalities", Gastrointest Endosc, 61, pp.854~861 (2005)
- Williams DB, "Endoscopic ultrasound guided fine needle aspiration biopsy: a large single centre experience", Gut, 44, pp.720~726 (1999)
- VArdengh JC, "Diagnosis of pancreatic tumors by endoscopic ultrasound-guided fine-needle aspiration", World J Gastroenterol, 13, pp.3112~3116 (2007)
- Savides TJ, "EUS-guided FNA diagnostic yield of malignancy in solid pancreatic masses: a benchmark for quality performance measurement", Gastrointest Endosc, 66, pp.277~282 (2007)
- VAithal GP, "EUSguided tissue sampling: comparison of "dual sampling" (Trucut biopsy plus FNA) with "sequential sampling" (Trucut biopsy and then FNA as required)", Endoscopy, 39, pp.725~730 (2007)
- Ginès A, "Prospective study of a Trucut needle for performing EUS-guided biopsy with EUS-guided FNA rescue", Gastrointest Endosc, 62, pp.597~601 (2005)
- Levy MJ, "EUS-guided Trucut biopsy", Gastrointest Endosc, 62, pp.417~426 (2005)
- Yasuda I, "Endoscopic ultrasound- guided fine-needle aspiration biopsy for lymphadenopathy of unknown origin", Endoscopy, 38, pp.919~924 (2006)
- Storch I, "Advantage of EUS Trucut biopsy combined with fine-needle aspiration without immediate on-site cytopathologic examination", Gastrointest Endosc, 64, pp.505~511 (2006)
- Boudghène FP, "US and CT imaging features of intrapancreatic metastases", J Comput Assist Tomogr, 18, pp.905~910 (1994)
- Ferrozzi F, "Pancreatic metastases: CT assessment", Eur Radiol, 7, pp.241~245 (1997)