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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(01): E155-E163
DOI: 10.1055/a-2240-0678
Original article

Clinical usefulness of tissue acquisition of pancreatic cystic lesions using an endoscopic ultrasound-guided needle for histological analysis

Juliana Silveira Lima de Castro 
1   Diagnostic Imaging, Universidade Federal de Sao Paulo Departamento de Diagnostico por Imagem, Sao Paulo, Brazil (Ringgold ID: RIN368471)
2   Endoscopy, ACCamargo Cancer Center, Sao Paulo, Brazil (Ringgold ID: RIN139300)
,
Eloy Taglieri
2   Endoscopy, ACCamargo Cancer Center, Sao Paulo, Brazil (Ringgold ID: RIN139300)
3   Endoscopy, Hospital Moriah, Sao Paulo, Brazil (Ringgold ID: RIN476599)
4   Endoscopy, Hospital 9 de Julho, Sao Paulo, Brazil (Ringgold ID: RIN245166)
,
Otávio Micelli Neto
2   Endoscopy, ACCamargo Cancer Center, Sao Paulo, Brazil (Ringgold ID: RIN139300)
3   Endoscopy, Hospital Moriah, Sao Paulo, Brazil (Ringgold ID: RIN476599)
4   Endoscopy, Hospital 9 de Julho, Sao Paulo, Brazil (Ringgold ID: RIN245166)
,
João Guilherme Guerra
2   Endoscopy, ACCamargo Cancer Center, Sao Paulo, Brazil (Ringgold ID: RIN139300)
3   Endoscopy, Hospital Moriah, Sao Paulo, Brazil (Ringgold ID: RIN476599)
,
Filadélfio Euclides Venco
5   Pathology, Hospital Moriah, Sao Paulo, Brazil (Ringgold ID: RIN476599)
,
Eliza Andrade
2   Endoscopy, ACCamargo Cancer Center, Sao Paulo, Brazil (Ringgold ID: RIN139300)
,
Alvaro Moura Seraphim
2   Endoscopy, ACCamargo Cancer Center, Sao Paulo, Brazil (Ringgold ID: RIN139300)
,
Samuel Galante Romanini
4   Endoscopy, Hospital 9 de Julho, Sao Paulo, Brazil (Ringgold ID: RIN245166)
,
Isabela Trindade Torres
4   Endoscopy, Hospital 9 de Julho, Sao Paulo, Brazil (Ringgold ID: RIN245166)
,
Juan Pablo Roman Serrano 
6   Endoscopy, Hospital General Luis Vernaza, Guayaquil, Ecuador (Ringgold ID: RIN92938)
,
Suzan Menasce Goldman
1   Diagnostic Imaging, Universidade Federal de Sao Paulo Departamento de Diagnostico por Imagem, Sao Paulo, Brazil (Ringgold ID: RIN368471)
,
Rafael Kemp
7   Surgery and Anatomy, Universidade de Sao Paulo Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto, Ribeirao Preto, Brazil (Ringgold ID: RIN67796)
,
José Sebastião dos Santos
7   Surgery and Anatomy, Universidade de Sao Paulo Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto, Ribeirao Preto, Brazil (Ringgold ID: RIN67796)
,
José Celso Ardengh 
1   Diagnostic Imaging, Universidade Federal de Sao Paulo Departamento de Diagnostico por Imagem, Sao Paulo, Brazil (Ringgold ID: RIN368471)
3   Endoscopy, Hospital Moriah, Sao Paulo, Brazil (Ringgold ID: RIN476599)
7   Surgery and Anatomy, Universidade de Sao Paulo Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto, Ribeirao Preto, Brazil (Ringgold ID: RIN67796)
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Histologic analysis of pancreatic cystic lesions: Is tissue the issue?Endosc Int Open 2024; 12(03): E341-E343
DOI: 10.1055/a-2241-8038

Abstract

Background and study aims There are rare data on the usefulness of endosonography-guided tissue acquisition (EUS-TA) in patients with pancreatic cystic lesions (PCLs). This study aimed to determine the accuracy of EUS-TA with ProCore 20G (PC20) for differentiating between mucinous neoplasia (MN) and non-MNs (n-MN) and identifying malignant PCLs, as well as its adverse events (AEs) in patients with PCLs without a classificatory diagnosis by imaging exams.

Patients and methods In this observational, retrospective, single-center study, all patients with PCL who underwent EUS-TA due to diagnostic doubts in imaging studies were consecutively recruited from June 2017 to December 2021. The outcomes were to determine the diagnostic accuracy of EUS-TA with PC20 for differentiating between MN and n-MN, identifying malignant PCLs, and the AEs.

Results Herein, 145 patients underwent EUS-TA, with 83 women (57.2%) and a mean age of 62.2 years. The mean size was 2.3 cm, with 81 patients (77.9%) having a PCL < 3.0 cm. The final diagnosis was made by EUS-TA (n = 81), surgery (n = 58), and follow-up (n = 6). The sensitivity, specificity, positive and negative predictive values, and accuracy for differentiating between MNs and n-MNs and identifying malignant PCLs were 92.6%, 98.4%, 98.7%, 91.3%, and 95.2% (kappa=0.9), and 92%, 99.2%, 95.8%, 98.3%, and 97.9% (kappa = 0.93), respectively. The AE rate was 2.7%, with no deaths in this cohort.

Conclusions EUS-TA with PC20 has high accuracy and technical success with a low AE rate for PCL diagnosis.

Keywords

Fine-needle aspiration/biopsy - Endoscopic ultrasonography - Intervention EUS - Pancreas - Tissue diagnosis


Publication History

Received: 01 August 2023

Accepted after revision: 04 January 2024

Accepted Manuscript online:
08 January 2024

Article published online:
30 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2024; 56(04): 321-321
DOI: 10.1055/a-2241-6227

 

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