Factors Influencing the Diagnostic Performance of Repeat Endoscopic Ultrasound-Guided Fine-Needle Aspiration/Biopsy after the First Inconclusive Diagnosis of Pancreatic Solid Lesionsopen access
- Authors
- Cho, Jae Hee; Kim, Jaihwan; Lee, Hee Seung; Ryu, Su Jeong; Jang, Sung Ill; Kim, Eui Joo; Kang, Huapyong; Lee, Sang Soo; Song, Tae Jun; Bang, Seungmin
- Issue Date
- Jan-2024
- Publisher
- EDITORIAL OFFICE GUT & LIVER
- Keywords
- Endoscopic ultrasound-guided fine needle aspiration; Biopsy; Pancreatic neoplasms
- Citation
- GUT AND LIVER, v.18, no.1, pp 184 - 191
- Pages
- 8
- Journal Title
- GUT AND LIVER
- Volume
- 18
- Number
- 1
- Start Page
- 184
- End Page
- 191
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/91068
- DOI
- 10.5009/gnl220529
- ISSN
- 1976-2283
2005-1212
- Abstract
- Background/Aims: Endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) is essential in diagnosing solid pancreatic lesions (SPLs), but without rapid on-site evaluation (ROSE), a repeat EUS-FNA/B is crucial for clarifying an inconclusive diagnosis. We aimed to evaluate factors associated with improved diagnostic performance of repeat EUS-FNA/B for initially inconclusive SPL diagnoses without ROSE.Methods: Of 5,894 patients subjected to EUS-FNA/B, 237 (4.0%) with an initially inconclusive diagnosis of SPLs were retrospectively enrolled from five tertiary medical centers between January 2016 and June 2021. Diagnostic performance and procedural factors of EUS-FNA/B were analyzed.Results: The diagnostic accuracies of first and repeat EUS-FNA/B were 96.2% and 67.6%, respectively. Of 237 patients with an inconclusive diagnosis from initial EUS-FNA/B, 150 were pathologically diagnosed after repeat EUS-FNA/B. In multivariate analysis of repeat EUS-FNA/B, tumor location (body/tail vs head: odds ratio [OR], 3.74; 95% confidence interval [CI], 1.48 to 9.46), number of needle passes (>_4 vs & LE;3: OR, 4.80; 95% CI, 1.44 to 15.99), needle type (FNB vs FNA: OR, 3.26; 95% CI, 1.44 to 7.36), needle size (22 gauge vs 19/20 gauge: OR, 2.35; 95% CI, 1.19 to 4.62), and suction method (suction vs others: OR, 5.19; 95% CI, 1.30 to 20.75) were associated with a significantly improved diagnostic performance.Conclusions: Repeat EUS-FNA/B is essential for patients with an inconclusive EUS-FNA/B without ROSE. To improve the diagnostic performance of repeated EUS-FNA/B, it is recommended that 22-gauge FNB needles, >_4 needle passes, and suction methods are used. (Gut Liver, Published online June 15, 2023)
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