Endoscopy 2020; 52(S 01): S93
DOI: 10.1055/s-0040-1704282
ESGE Days 2020 oral presentations
Friday, April 24, 2020 11:00 – 13:00 Pancreatic solid tumors Liffey Meeting Room 1
© Georg Thieme Verlag KG Stuttgart · New York

EFFECT OF HISTOLOGICAL EXAMINATION ON DIAGNOSTIC ACCURACY IN ENDOSCOPIC ULTRASOUND FINE-NEEDLE ASPIRATION

SJ Choi
1   Korea University College of Medicine, Department of Internal Medicine, Seoul, Korea, Republic of
,
CD Kim
1   Korea University College of Medicine, Department of Internal Medicine, Seoul, Korea, Republic of
,
KW Lee
1   Korea University College of Medicine, Department of Internal Medicine, Seoul, Korea, Republic of
,
SH Kim
1   Korea University College of Medicine, Department of Internal Medicine, Seoul, Korea, Republic of
,
HJ Jeon
1   Korea University College of Medicine, Department of Internal Medicine, Seoul, Korea, Republic of
,
JM Lee
1   Korea University College of Medicine, Department of Internal Medicine, Seoul, Korea, Republic of
,
HS Choi
1   Korea University College of Medicine, Department of Internal Medicine, Seoul, Korea, Republic of
,
ES Kim
1   Korea University College of Medicine, Department of Internal Medicine, Seoul, Korea, Republic of
,
B Keum
1   Korea University College of Medicine, Department of Internal Medicine, Seoul, Korea, Republic of
,
YT Jeen
1   Korea University College of Medicine, Department of Internal Medicine, Seoul, Korea, Republic of
,
HJ Chun
1   Korea University College of Medicine, Department of Internal Medicine, Seoul, Korea, Republic of
,
HS Lee
1   Korea University College of Medicine, Department of Internal Medicine, Seoul, Korea, Republic of
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Publikationsdatum:
23. April 2020 (online)

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    Aims Diagnostic yield of EUS-FNA for pancreatic lesions varies around 70-90%, affected by many factors including tissue processing.In order to increase the diagnostic accuracy, we evaluated the effect of histological examination of core tissues acquired from EUS-FNA.

    Methods A single-center observational study was conducted at a tertiary university hospital. The patients who underwent EUS-FNA for pancreatic lesion using 22G EUS-FNA needle were included only if a core was observed from the retrieved specimen. A total of 63 patients was enrolled. For liquid-based cytology, the specimen was directly expressed into a liquid-based fixation medium for processing, and cellblock was also made for the evaluation. The whitish core was withdrawn before any process for cytology was made and was placed in a container of 10% neutral-buffered formalin fixative for the histologic evaluation.

    Results In total 63 patients, 61 patients were finally diagnosed as pancreatic cancer and 2 patients had benign lesions. Cytologic diagnosis showed sensitivity of 73.8 %, specificity of 100.00%, accuracy of 74.6 %, positive predictive value (PPV) of 100.0 % and negative predictive value (NPV) of 11.1 %. Histologic diagnosis showed sensitivity of 68.9 %, specificity of 100.0 %, accuracy of 69.8 %, PPV of 100 % and NPV of 9.5 %. Overall diagnostic yield of EUS-FNA showed increased sensitivity of 86.9 %, specificity of 100.0 %, accuracy of 87.3 %, PPV of 100.0 % and NPV of 20.0 %. We also compared the weight of the core and needle depth from the surface of the lesion between the histology positive and negative group, but there were no significance.

    Conclusions Histologic evaluation of core material obtained from EUS-FNA improved diagnostic sensitivity, accuracy, and NPV, and histologic results had higher ratio of atypical cell over negative result, providing more clinical information. Further studies with prospective randomized trial is recommended to support our data.


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