Endoscopic ultrasound-guided fine needle aspiration for pancreatic cancer

Suzuki, Rei; Takagi, Tadayuki; Sugimoto, Mitsuru; Konno, Naoki; Sato, Yuki; Irie, Hiroki; Watanabe, Ko; Nakamura, Jun; Takasumi, Mika; Hashimoto, Minami; Hikichi, Takuto; Ohira, Hiromasa

doi:10.5387/fms.2018-14

Cited by 6 publications

(7 citation statements)

References 33 publications

(19 reference statements)

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“…Hewitt et al (21) performed a meta-analysis of 4984 patients and demonstrated a pooled sensitivity of 0.85 and a specificity of 0.98 for malignant cytology. Reports have shown that the accuracies of T-staging by EUS range from 62-94%, and those of N-staging range from 50-86% (22). Although EUS-FNA provides a valuable means for pancreatic cancer diagnosis, it shows a poor staging performance, and it is invasive and limited to the detection location of the tumor.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Ductal Adenocarcinoma at CT: A Combined Nomogram Model to Preoperatively Predict Cancer Stage and Survival Outcome

Cen

Liu

et al. 2021

Front. Oncol.

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ObjectivesTo construct a nomogram model that combines clinical characteristics and radiomics signatures to preoperatively discriminate pancreatic ductal adenocarcinoma (PDAC) in stage I-II and III-IV and predict overall survival.MethodsA total of 135 patients with histopathologically confirmed PDAC who underwent contrast-enhanced CT were included. A total of 384 radiomics features were extracted from arterial phase (AP) or portal venous phase (PVP) images. Four steps were used for feature selection, and multivariable logistic regression analysis were used to build radiomics signatures and combined nomogram model. Performance of the proposed model was assessed by using receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis (DCA). Kaplan-Meier analysis was applied to analyze overall survival in the stage I-II and III-IV PDAC groups.ResultsThe AP+PVP radiomics signature showed the best performance among the three radiomics signatures [training cohort: area under the curve (AUC) = 0.919; validation cohort: AUC = 0.831]. The combined nomogram model integrating AP+PVP radiomics signature with clinical characteristics (tumor location, carcinoembryonic antigen level, and tumor maximum diameter) demonstrated the best discrimination performance (training cohort: AUC = 0.940; validation cohort: AUC = 0.912). Calibration curves and DCA verified the clinical usefulness of the combined nomogram model. Kaplan-Meier analysis showed that overall survival of patients in the predicted stage I-II PDAC group was longer than patients in stage III-IV PDAC group (p<0.0001).ConclusionsWe propose a combined model with excellent performance for the preoperative, individualized, noninvasive discrimination of stage I-II and III-IV PDAC and prediction of overall survival.

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Section: Discussionmentioning

confidence: 99%

Pancreatic Ductal Adenocarcinoma at CT: A Combined Nomogram Model to Preoperatively Predict Cancer Stage and Survival Outcome

Cen

Liu

et al. 2021

Front. Oncol.

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“…In recent years, EUS-FNA has been widely applied to diagnose lesions in the digestive tract and nearby areas. This diagnostic technique is suitable for diagnosing submucosal tumors in the digestive tract ( 2 ), and space-occupying lesions in the lymph nodes ( 3 ), mediastinum ( 4 , 5 ), pancreas ( 6 , 7 ), liver ( 8 ), and adrenal glands ( 9 , 10 ). The clinical value of EUS-FNA for diagnosing space-occupying lesions in these organs has been widely acknowledged.…”

Section: Introductionmentioning

confidence: 99%

Transrectal endoscopic ultrasound-guided fine-needle aspiration biopsy for qualitative diagnosis of pelvic space-occupying lesions: a diagnostic test

Cai¹,

Cheng²,

Fang³

et al. 2022

Transl Cancer Res TCR

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Background: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is an effective technique for qualitative diagnosis of space occupying lesions in and around the wall of the digestive tract. At present, there are many studies on EUS-FNA via the upper gastrointestinal route, while there are few studies on EUS-FNA via the lower gastrointestinal route, especially for Chinese patients with pelvic mass. Therefore, this study sought to evaluate the value of transrectal EUS-FNA in the qualitative diagnosis of pelvic masses in Chinese patients. Methods:The clinical data of 35 patients with pelvic masses who underwent EUS-FNA at our hospital were collected from September 2014 to December 2021. Among these patients, 10 underwent surgical treatment after EUS-FNA, and a diagnosis was made based on a pathologic evaluation. The EUS-FNA biopsy results were compared to the final diagnostic results to calculate the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of EUS-FNA in the diagnosis of malignant pelvic mass. For the 10 patients who underwent surgery, the final diagnoses were based on the pathologic findings of surgical specimens, and for the 25 patients who did not undergo surgery, the final diagnoses were based on the malignant pathological results of EUS-FNA or clinical follow-up results.Results: Among the 35 patients, 12 had benign lesions, including pelvic abscesses, cysts, and inflammatory masses, and 23 had malignant lesions, including mesenchymal tumors, leiomyosarcomas, teratomas, and malignant tumors with pelvic metastases. There were no complications resulting from the biopsy punctures.The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EUS-FNAs for the diagnosis of malignant pelvic masses were 91.3% (21/23), 100.0% (12/12), 100.0% (21/21), 85.7% (12/14), and 94.3% (33/35), respectively.Conclusions: EUS-FNA is a safe and effective method for the qualitative diagnosis of pelvic masses, and has good clinical application value.

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“…Pancreatic cancer is a highly aggressive tumor with a poor prognosis (1). Its mortality almost equals incidence and the 5-year survival rate is only 6% (2). The low survival rate is due to the late presentation of symptoms, which often results in a delayed diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…The advent of endoscopic ultrasonography (EUS) and EUS-guided fine needle aspiration (EUS-FNA) has provided an important diagnostic method for various visceral malignancies, especially pancreatic lesions (4)(5)(6). EUS-FNA can provide real-time and direct visualization of structures within or outside the gastrointestinal lumen and can obtain an adequate sample, which is critical for precise diagnosis and management (2,7). A recent metaanalysis of randomized controlled trials revealed that the sensitivity of EUS-FNA is about 85-93% (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic ultrasonography guided transgastric trans-portal system fine needle aspiration for diagnosing pancreatic head and uncinate process malignancy

Wang¹,

Huang²,

Pei³

et al. 2019

Ann Transl Med

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Background: Endoscopic ultrasonography guided fine needle aspiration (EUS-FNA) is a well-established technique for diagnosing pancreatic malignancy. In general, tissue of pancreatic head and uncinate process lesions is obtained via a transduodenal approach. However, this tissue-acquisition modality is not applicable in cases of pyloric obstruction and duodenal bulb ulceration. The aim of this study is to determine the feasibility and safety of a novel EUS-guided transgastric trans-portal system FNA in the diagnosis of pancreatic head and uncinate process cancer.Methods: This study retrospectively analyzed 26 consecutive inpatient patients who had undergone EUS-FNA for highly suspected malignancy of pancreatic head or uncinate process between December 2013 and December 2018. EUS-guided transgastric trans-portal vein (trans-PV, n=2) or trans-superior mesenteric vein (trans-SMV, n=24) FNA was performed in the patients under conscious sedation. Feasibility, diagnostic yield and complication rates of the technique were evaluated.Results: Specimens obtained by EUS-guided transgastric trans-portal system FNA were adequate for cytological evaluation in all 26 patients. Cytological diagnosis of adenocarcinoma was established in 22 patients, while the remaining 4 patients were negative. The diagnostic accuracy, sensitivity and specificity were 92.3%, 91.7% and 100% respectively. No immediate or delayed procedure-related complications were observed.Conclusions: EUS-guided transgastric trans-portal system FNA is a feasible and probably safe method for diagnosing pancreatic head and uncinate process malignancy. Careful selection of the potential candidates and close periprocedural observation are mandatory.

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Endoscopic ultrasound-guided fine needle aspiration for pancreatic cancer

Cited by 6 publications

References 33 publications

Pancreatic Ductal Adenocarcinoma at CT: A Combined Nomogram Model to Preoperatively Predict Cancer Stage and Survival Outcome

Pancreatic Ductal Adenocarcinoma at CT: A Combined Nomogram Model to Preoperatively Predict Cancer Stage and Survival Outcome

Transrectal endoscopic ultrasound-guided fine-needle aspiration biopsy for qualitative diagnosis of pelvic space-occupying lesions: a diagnostic test

Endoscopic ultrasonography guided transgastric trans-portal system fine needle aspiration for diagnosing pancreatic head and uncinate process malignancy

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