Efficacy of 3 fine-needle biopsy techniques for suspected pancreatic malignancies in the absence of an on-site cytopathologist
- Abstract
- BACKGROUND AND AIMS: EUS-guided fine-needle aspiration/biopsy (EUS-FNA/B) has a high diagnostic accuracy for pancreatic tumors. Most reports have focused on the diagnostic yield of cytology or histology; the ability of various FNA/B techniques to obtain an adequate mass of cells or tissue has rarely been investigated. METHODS: Patients with suspected pancreatic malignancy underwent EUS-FNB using a 22-gauge ProCore needle by either the stylet slow-pull-back technique (group A), conventional negative suction after stylet removal (group B), or non-suction after stylet removal (group C) in the absence of an on-site cytopathologist. The adequacy of the 3 techniques based on the diagnostic yield, cellularity, blood contamination, and core-tissue acquisition was evaluated. RESULTS: A total of 50 patients (27 males) were analyzed. The mean tumor size was 21 to 40mm in 54%. The rate of a good or excellent proportion of cellularity was highest in group A compared with groups B and C (72% vs 60% vs 50%, P= .049). A >25% rate of blood contamination was more prevalent in group B (30% vs 42% vs 10%, P= .009). The rate of adequate core-tissue acquisition was not different (52% vs 34% vs 50%, P= .140). Based on the multivariate generalized estimation equation, the stylet slow-pull-back technique and a tumor size >40mm were favorable factors for diagnostic adequacy. CONCLUSIONS: The stylet slow-pull-back technique might enable acquisition of tissue and assessment of cellularity for the diagnosis of pancreatic tumors suspected to be malignant. (Clinical trial registration number: KCT0002190.).
- All Author(s)
- K. Y. Lee
; H. D. Cho
; Y. Hwangbo
; J. K. Yang
; S. J. Han
; H. J. Choi
; Y. N. Lee
; S. W. Cha
; J. H. Moon
; Y. D. Cho
; S. H. Park
; T. H. Lee
- Issued Date
- 2019
- Type
- Article
- Keyword
- Aged; Endoscopic Ultrasound-Guided Fine Needle Aspiration/*methods; Female; Humans; Male; Middle Aged; Multivariate Analysis; Neuroendocrine Tumors/diagnosis/*pathology; Pancreatic Intraductal Neoplasms/diagnosis/*pathology; Pancreatic Neoplasms/diagnosis/*pathology; Tumor Burden
- Publisher
- American Society for Gastrointestinal Endoscopy
- ISSN
- 0016-5107
- Citation Title
- Gastrointestinal Endoscopy
- Citation Volume
- 89
- Citation Number
- 4
- Citation Start Page
- 825
- Citation End Page
- 831, e1
- Language(ISO)
- eng
- DOI
- 10.1016/j.gie.2018.10.042
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2767
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