Value of EUS-FNA cytological preparations compared with cell block sections in the diagnosis of pancreatic solid tumours

Kopelman, Yael; Marmor, Sylvia; Ashkenazi, Itamar; Fireman, Zvi

doi:10.1111/j.1365-2303.2010.00766.x

Cited by 42 publications

(34 citation statements)

References 16 publications

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“…Nevertheless, studies have shown that cell block is a valid technique for performing histologic assessments, and it can improve the diagnostic accuracy of smears. 21-23 Finally, it was not possible to blind the endoscopist to the type of device used for sampling pancreatic masses, which could have introduced bias into our study. 24 However, this may not be a major limitation because the pathologist was blinded to the type of accessory used for tissue procurement.…”

Section: Discussionmentioning

confidence: 99%

Randomized trial comparing the 22-gauge aspiration and 22-gauge biopsy needles for EUS-guided sampling of solid pancreatic mass lesions

Bang

Hébert‐Magee

Trevino

et al. 2012

Gastrointestinal Endoscopy

255

280

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Background: To overcome limitations of cytology, biopsy needles have been developed to procure histologic samples during EUS. Objective: To compare 22-gauge (G) FNA and 22G biopsy needles (FNB) for EUS-guided sampling of solid pancreatic masses. Design: Randomized trial. Setting: Tertiary-care medical center. Patients: This study involved 56 patients with solid pancreatic masses. Intervention: Sampling of pancreatic masses by using 22G FNA or 22G FNB devices. Main Outcome Measurements: Compare the median number of passes required to establish the diagnosis, diagnostic sufficiency, technical performance, complication rates, procurement of the histologic core, and quality of the histologic specimen. Results: A total of 28 patients were randomized to the FNA group and 28 to the FNB group. There was no significant difference in median number of passes required to establish the diagnosis (1 [interquartile range 1-2.5] vs 1 [interquartile range 1-1]; P = .21), rates of diagnostic sufficiency (100% vs 89.3%; P = .24), technical failure (0 vs 3.6%; P = 1.0), or complications (3.6% for both) between FNA and FNB needles, respectively. Patients in whom diagnosis was established in passes 1, 2, and 3 were 64.3% versus 67.9%, 10.7% versus 17.9%, and 25% versus 3.6%, respectively, for FNA and FNB cohorts. There was no significant difference in procurement of the histologic core (100% vs 83.3%; P = .26) or the presence of diagnostic histologic specimens (66.7% vs 80%; P = .66) between FNA and FNB cohorts, respectively. Limitations: Only pancreatic masses were evaluated. Conclusion: Diagnostic sufficiency, technical performance, and safety profiles of FNA and FNB needles are comparable. There was no significant difference in yield or quality of the histologic core between the 2 needle types. (Clinical trial registration number: AQ:NCT01394159.) (Gastrointest Endosc 2012;76:321-7.)

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Section: Discussionmentioning

confidence: 99%

Randomized trial comparing the 22-gauge aspiration and 22-gauge biopsy needles for EUS-guided sampling of solid pancreatic mass lesions

Bang

Hébert‐Magee

Trevino

et al. 2012

Gastrointestinal Endoscopy

255

280

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“…Moreover, immunostaining of serial sections is commonly used for a definitive cytohistological diagnosis [25], [26]. Compared to SC and LBC, CB immunohistochemistry was much more reliable owing to the gold standard of histological staining regardless of lesion location or approaching routes [27], [28]. A prospective study reported that the efficacy of CB immunohistochemistry was significantly higher than that of SC for the detection of malignancies and benign lesions [18].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Efficacy of Cell Block Immunohistochemistry, Smear Cytology, and Liquid-Based Cytology in Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Pancreatic Lesions: A Single-Institution Experience

Qin

Zhou

et al. 2014

PLoS ONE

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BackgroundThe diagnostic efficiency of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytology varies widely depending on the treatment method of the specimens. The present study aimed to evaluate the diagnostic efficacy of cell block (CB) immunohistochemistry, smear cytology (SC), and liquid-based cytology (LBC) in patients with pancreatic lesions without consulting an on-site cytopathologist.MethodsThis study prospectively enrolled 72 patients with pancreatic lesions. The EUS-FNA specimens were examined by SC, LBC, and CB immunohistochemistry. The diagnostic efficacy of the 3 methods was then compared. Patients’ final diagnosis was confirmed by surgical resection specimens, diagnostic imaging, and clinical follow-up.ResultsOur results included 60 malignant and 12 benign pancreatic lesions. The diagnostic sensitivity (90%), negative predictive value (66.7%), and accuracy (91.7%) of CB immunohistochemistry were significantly higher than those of SC (70.0%, 30.0%, and 75.0%, respectively) and LBC (73.3%, 31.6%, and 77.8%, respectively) (all P<0.05). The combination of CB and SC, or CB and LBC, did not significantly increase the efficacy compared to CB immunohistochemistry alone.ConclusionOur findings suggest that in the absence of an on-site cytopathologist, CB immunohistochemistry on EUS-FNA specimens offers a higher diagnostic efficacy in patients with pancreatic lesions than does SC and LBC.

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“…Nevertheless, studies have shown that cell block is a valid technique for performing histologic assessments, and it can improve the diagnostic accuracy of smears. [15][16][17] Given the study findings, the logical question is this: What is the role of the new flexible 19-G needle in EUS? In our opinion, the needle can yield both cytologic aspirates and histologic specimens in more than 90% of patients irrespective of the location of the mass.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the technical performance of the flexible 19-gauge EUS-FNA needle

Varadarajulu¹,

Bang²,

Hébert‐Magee³

2012

Gastrointestinal Endoscopy

103

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Value of EUS-FNA cytological preparations compared with cell block sections in the diagnosis of pancreatic solid tumours

Abstract: EUS-FNA cytology was more sensitive than cell blocks but less specific for the diagnosis of solid pancreatic lesions. The two methods are complementary and implementing both improves the diagnostic value of EUS-FNA.

Cited by 42 publications

References 16 publications

Randomized trial comparing the 22-gauge aspiration and 22-gauge biopsy needles for EUS-guided sampling of solid pancreatic mass lesions

Randomized trial comparing the 22-gauge aspiration and 22-gauge biopsy needles for EUS-guided sampling of solid pancreatic mass lesions

Diagnostic Efficacy of Cell Block Immunohistochemistry, Smear Cytology, and Liquid-Based Cytology in Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Pancreatic Lesions: A Single-Institution Experience

Assessment of the technical performance of the flexible 19-gauge EUS-FNA needle

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