Impact of endoscopic ultrasound‐guided fine‐needle biopsy on the diagnosis of subepithelial tumors: A propensity score‐matching analysis

Inoue, Tadahisa; Okumura, Fumihiro; Sano, Hitoshi; Mizushima, Takashi; Tsukamoto, Hironobu; Fujita, Yasuaki; Ibusuki, Mayu; Kitano, Rena; Kobayashi, Yuji; Ishii, Norimitsu; Ito, Kiyoaki; Yoneda, Masashi

doi:10.1111/den.13269

Cited by 34 publications

(43 citation statements)

References 23 publications

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“…If patient developed clinical or radiographic evidence of local or distant metastasis based on clinical records were considered as positive for malignancy [17] [18]. If patient lacked disease progression, his lesion was defined as negative for malignancy [14].…”

Section: Discussionmentioning

confidence: 99%

“…EUS guided FNAC has integrated into the diagnostic and staging algorithm for evaluation of benign and malignant submucosal lesions of the gastrointestinal tract and adjacent organs [14].…”

Section: Discussionmentioning

confidence: 99%

“…Adequate EUS-FNA cytology samples, of gastrointestinal lesions and related organs with exception of pancreatic lesions were interpreted as negative, atypical cells, suspicious of malignancy and malignant [14].…”

Section: Cytological Evaluationmentioning

confidence: 99%

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Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology of Gastrointestinal Tract Tumors and Related Organs: Predictive Factors for Accurate Cytopathological Diagnosis

Ameen¹,

Hafez²,

Yassen³

et al. 2020

OJPathology

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Background: Endoscopic ultrasonography (EUS) is well-established, highly accurate clinical diagnostic test for detection and staging of gastrointestinal tract lesions and related organs. The addition of endoscopic guided fine needle aspiration cytology (EUS-FNAC) has improved the performance characteristics of EUS. Aim: Evaluate the validity of EUS-FNAC in diagnosis of gastrointestinal tract lesions and related organs and assess predictive factors for an accurate EUS-FNAC diagnosis. Methods: Our study included cytological sampling from one hundred sixty-six lesions obtained from gastrointestinal tract and related organs. Factors affecting EUS-FNA accuracy were analyzed. The histopathological results or clinical follow-up were used as the gold standard method. Results: Samples were obtained from: pancreatic masses (n = 80), gastric masses (n = 34), lymph nodes (n = 22), hepatobiliary masses (n = 18) and rectal masses (n = 2). Statistical analysis of sensitivity, specificity, Positive Predictive Value, Negative Predictive Value, and diagnostic accuracy of EUS alone was 80.4%, 51.6%, 75.8%, 76.2% and 75.9% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of EUS-FNAC are 78.8%, 96.8%, 97.6% and 73.2% respectively. Addition of FNAC to EUS improved diagnostic accuracy to 85.5%. Positive statistical association was present between cytological adequacy and adequate cell block preparations, larger lesion size, presence of rapid on site evaluation (ROSE) and obtaining at least two passes from target lesion. Conclusions: EUS is valuable diagnostic and cost effective tool for gastrointestinal tract lesions and related organs when combined with FNAC.

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Section: Discussionmentioning

confidence: 99%

“…EUS guided FNAC has integrated into the diagnostic and staging algorithm for evaluation of benign and malignant submucosal lesions of the gastrointestinal tract and adjacent organs [14].…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology of Gastrointestinal Tract Tumors and Related Organs: Predictive Factors for Accurate Cytopathological Diagnosis

Ameen¹,

Hafez²,

Yassen³

et al. 2020

OJPathology

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“…An endoscopic ultrasound‐guided fine‐needle aspiration/biopsy (EUS‐FNAB) is the gold‐standard method for evaluating the pathology of subepithelial lesions (SELs). Although new FNAB needles and techniques for tissue sampling have been developed, we sometimes encounter cases with difficulty in obtaining a sufficient sample for an immunohistological study, especially with gastric SELs <20 mm in size. The difficulty is mostly attributed to the mobility of the SEL.…”

Section: Brief Explanationmentioning

confidence: 99%

Forward‐viewing endoscopic ultrasound‐guided fine‐needle biopsy using the clip‐with‐thread method for small gastric subepithelial lesions

Minoda

Fujimori

Ihara

2019

Digestive Endoscopy

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“…Endoscopic ultrasound-guided ne-needle aspiration (EUS-FNA) was introduced in the early 1990s [1,2] and has been widely used as a standard technique to obtain pathological specimens from lesions around the upper gastrointestinal tract (GI), such as pancreatic tumors [3][4][5][6], upper abdominal lymph nodes [7,8], mediastinal masses [9,10], or upper gastrointestinal submucosal tumors [11][12][13][14]. However, the feasibility and safety of EUS-FNA for lower abdominal lesions have not been well studied, although EUS-FNA for pelvic lesions via the lower GI approach was reported in several studies, including one systematic review and meta-analysis [15][16][17], in which target lesions were limited around the rectal or perirectal area.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound-guided fine-needle aspiration of pelvic lesions via the upper and lower gastrointestinal tract approaches

Mita

Iwashita

Senju

et al. 2020

Preprint

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Background Combining upper and lower gastrointestinal tract (GI) approaches allows expansion of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) indications for pelvic lesions. The upper GI approach has been used for pelvic lesions around the level of the aortoiliac bifurcation in our institution. The aim of this study is to evaluate the feasibility and safety of EUS-FNA for pelvic lesions via the upper and lower GI approaches. Methods All consecutive patients who underwent EUS-FNA for the pelvic lesion between January 2008 and December 2018 were retrospectively analyzed. Pelvic lesions were defined as lesions located around and below the aortoiliac bifurcation level. The primary outcome was technical success rate, and the secondary outcomes were the diagnostic capability of EUS-FNA for malignancy and the safety. Results EUS-FNA for pelvic lesions was performed in 49 patients—upper and lower GI approaches were used in 28 and 21 patients, respectively. The technical success rates were 91.8% (45/49) in all patients—89.3% (25/28) and 95.2% (20/21) with the upper and lower GI approaches, respectively. Among patients who achieved technical success, the diagnostic accuracy for malignancy was 97.8% (44/45) in all patients—100% (25/25) and 95.0% (19/20) with the upper and lower GI approaches, respectively. One (2.0%) patient developed an adverse event of sigmoid colon perforation. Conclusions EUS-FNA for pelvic lesions via the upper and lower GI approaches was a safe, feasible, and effective method, although careful endoscopic manipulation is reuqired to avoid perforation, especially with the lower GI approach. Further large-scale, well-designed studies are needed to validate our findings.

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Impact of endoscopic ultrasound‐guided fine‐needle biopsy on the diagnosis of subepithelial tumors: A propensity score‐matching analysis

Abstract: Fine-needle biopsy needles can be useful for obtaining samples that facilitate the diagnosis of SET and for avoiding unwarranted resections. However, FNB needles may be less advantageous for small SET.

Cited by 34 publications

References 23 publications

Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology of Gastrointestinal Tract Tumors and Related Organs: Predictive Factors for Accurate Cytopathological Diagnosis

Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology of Gastrointestinal Tract Tumors and Related Organs: Predictive Factors for Accurate Cytopathological Diagnosis

Forward‐viewing endoscopic ultrasound‐guided fine‐needle biopsy using the clip‐with‐thread method for small gastric subepithelial lesions

Endoscopic ultrasound-guided fine-needle aspiration of pelvic lesions via the upper and lower gastrointestinal tract approaches

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