EUS-guided fine-needle tissue acquisition by using a 19-gauge needle in a selected patient population: a prospective study - 27/08/11
Reprint requests: Alberto Larghi, MD, PhD, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, ItalyRésumé |
Background |
The ability to obtain tissue samples for histological examination during EUS has theoretical advantages over cytology alone.
Objective |
To prospectively evaluate the feasibility and yield of EUS-guided fine-needle tissue acquisition (EUS-FNTA) with a large-gauge needle in patients in whom we expected histology to be more useful than cytology to reach a definitive diagnosis.
Design |
Prospective cohort study.
Setting |
Tertiary care academic medical center.
Patients |
Consecutive patients with subepithelial lesions, esophagogastric wall thickening, mediastinal and abdominal masses/lymphadenopathy of unknown origin, or pancreatic lesions after nondiagnostic FNA.
Interventions |
EUS-FNTA with a 19-gauge needle.
Main Outcome Measurements |
Feasibility and yield of EUS-FNTA.
Results |
A total of 120 patients with a mean age of 61 ± 14.6 years and mean lesion size of 38 ± 25 mm (range 8-140 mm) were enrolled. FNTA was successfully performed in all but 1 patient (98.9%), and adequate samples for histological examination were obtained in 116 of the 119 patients (97.5%) in whom EUS-FNTA was technically successful. A mean of 2.8 ± 0.8 passes per patient were performed. At the time of current follow-up, a definitive diagnosis was available in 117 of the 120 patients (97.5%), with only 8 false-negative results. The sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of EUS-FNTA in the 117 patients with a definitive diagnosis were 91.8%, 100%, 100%, 71.4%, and 93.2%, respectively.
Limitations |
Single-center study with limited power.
Conclusions |
EUS-FNTA by using a large-gauge needle has a high yield and promising diagnostic accuracy and could be used when histology may be more useful than cytology to reach a definitive diagnosis.
Le texte complet de cet article est disponible en PDF.Abbreviations : CLA, EUS-FNA, EUS-FNTA, EUS-TCB, FV, LQ, UQ
Plan
| DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: Dr Larghi: research support from Cook Endoscopy; Dr Costamagna: research support from Cook Endoscopy, Boston Scientific, and Olympus Corp. The other authors disclosed no financial relationships relevant to this publication. |
Vol 74 - N° 3
P. 504-510 - septembre 2011 Retour au numéro
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