Diagnostic yield of EUS-FNA of small (<= 15 mm) solid pancreatic lesions using a 25-gauge needle

作者：Crino Stefano Francesco^*; Bellocchi Maria Cristina Conti; Bernardoni Laura; Manfrin Erminia; Parisi Alice; Amodio Antonio; De Pretis Nicolo; Frulloni Luca; Gabbrielli Armando

来源：Hepatobiliary and Pancreatic Diseases International, 2018, 17(1): 70-74.

DOI：10.1016/j.hbpd.2018.01.010

• Endoscopic ultrasound
• Endoscopic ultrasound-guided fine needle aspiration
• Pancreatic cancer
• Benign pancreatic tumors
• Pancreatic neoplasms

Background: Early detection of small solid pancreatic lesions is increasingly common. To date, few and contradictory data have been published about the relationship between lesion size and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) diagnostic yield. The aim of this study was to assess the relation between the size of solid pancreatic lesions and the diagnostic yield of EUS-FNA using a 25-gauge needle in a center without available rapid on-site evaluation.
Methods: In the retrospective cohort study, we selected patients who underwent EUS-FNA for solid pancreatic lesions with a 25-gauge needle from October 2014 to October 2015. Patients were divided into three groups (<= 15 mm, 16-25 mm and >25 mm), and the outcomes were compared.
Results: We analyzed 163 patients. Overall adequacy, sensitivity, specificity and accuracy were 85.2%, 81.8%, 93.7%, and 80.4%, respectively. When stratified by size, the sensitivity and accuracy correlated with size (P = 0.016 and P = 0.042, respectively). Multivariate analysis showed that lesion size was the only independent factor (P = 0.019, OR = 4.76) affecting accuracy. The role of size as an independent factor affecting accuracy was confirmed in a separate multivariate analysis, where size was included in the model as a covariate (P = 0.018, OR = 1.08).
Conclusion: Our study demonstrates that, in the absence of rapid on-site evaluation, mass size affects the accuracy of EUS-FNA of solid pancreatic lesions.

• 出版日期2018-2