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Diagnostic Fine-Needle Biopsy of Small Solid Pancreatic Lesions Using a Franseen Needle during Endoscopic Ultrasound Examination

Background and aim: During endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNB), Franseen needles can help collect sufficient tissue to permit histopathological assessment. However, its efficacy might be limited by the size of the targeted lesion. This study aimed to evaluate the fea...

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Autores principales: Takahashi, Kosuke, Yasuda, Ichiro, Hanaoka, Tatsuyuki, Hayashi, Yuka, Araki, Yasuhiro, Motoo, Iori, Kajiura, Shinya, Ando, Takayuki, Fujinami, Haruka, Tajiri, Kazuto, Minemura, Masami, Takahara, Terumi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7823918/
https://www.ncbi.nlm.nih.gov/pubmed/33375661
http://dx.doi.org/10.3390/diagnostics11010027
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author Takahashi, Kosuke
Yasuda, Ichiro
Hanaoka, Tatsuyuki
Hayashi, Yuka
Araki, Yasuhiro
Motoo, Iori
Kajiura, Shinya
Ando, Takayuki
Fujinami, Haruka
Tajiri, Kazuto
Minemura, Masami
Takahara, Terumi
author_facet Takahashi, Kosuke
Yasuda, Ichiro
Hanaoka, Tatsuyuki
Hayashi, Yuka
Araki, Yasuhiro
Motoo, Iori
Kajiura, Shinya
Ando, Takayuki
Fujinami, Haruka
Tajiri, Kazuto
Minemura, Masami
Takahara, Terumi
author_sort Takahashi, Kosuke
collection PubMed
description Background and aim: During endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNB), Franseen needles can help collect sufficient tissue to permit histopathological assessment. However, its efficacy might be limited by the size of the targeted lesion. This study aimed to evaluate the feasibility of histopathological assessment of small solid pancreatic lesions using a 22-gauge Franseen needle during EUS-FNB. Methods: This retrospective study evaluated data from all patients who underwent EUS-FNB using a Franseen needle for solid pancreatic lesions at the University of Toyama Hospital between June 2018 and April 2020. Results: The study included 159 patients who had 152 malignant lesions and 7 benign lesions. The malignant lesions included pancreatic cancers (n = 134), neuroendocrine neoplasms (n = 15), metastatic tumors (n = 2), and a solid pseudopapillary neoplasm (n = 1). The diagnostic accuracy of EUS-FNB (combining histology and cytology) was 98.7%. However, the histopathological diagnosis was only confirmed for 64.3% of small lesions (<10 mm), relative to 97.2% for larger lesions. Multivariate analysis also revealed that lesion size of <10 mm predicted a less accurate histopathological diagnosis (odds ratio: 6.97, 95% confidence interval: 1.02–47.67; p = 0.041). Further analyses revealed a failed histological diagnosis in 4 patients with lesions of <5 mm in size and accurate diagnoses in 9 out of 10 patients with lesions of 5–10 mm in size. Conclusions: The diagnostic accuracy for small lesions (<10 mm), especially for lesions of <5 mm, based on histological examination alone, was significantly lower than that for others (>10 mm). Furthermore, multivariate analysis revealed that only lesion size was an independent predictor of histopathological diagnosis accuracy.
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spelling pubmed-78239182021-01-24 Diagnostic Fine-Needle Biopsy of Small Solid Pancreatic Lesions Using a Franseen Needle during Endoscopic Ultrasound Examination Takahashi, Kosuke Yasuda, Ichiro Hanaoka, Tatsuyuki Hayashi, Yuka Araki, Yasuhiro Motoo, Iori Kajiura, Shinya Ando, Takayuki Fujinami, Haruka Tajiri, Kazuto Minemura, Masami Takahara, Terumi Diagnostics (Basel) Article Background and aim: During endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNB), Franseen needles can help collect sufficient tissue to permit histopathological assessment. However, its efficacy might be limited by the size of the targeted lesion. This study aimed to evaluate the feasibility of histopathological assessment of small solid pancreatic lesions using a 22-gauge Franseen needle during EUS-FNB. Methods: This retrospective study evaluated data from all patients who underwent EUS-FNB using a Franseen needle for solid pancreatic lesions at the University of Toyama Hospital between June 2018 and April 2020. Results: The study included 159 patients who had 152 malignant lesions and 7 benign lesions. The malignant lesions included pancreatic cancers (n = 134), neuroendocrine neoplasms (n = 15), metastatic tumors (n = 2), and a solid pseudopapillary neoplasm (n = 1). The diagnostic accuracy of EUS-FNB (combining histology and cytology) was 98.7%. However, the histopathological diagnosis was only confirmed for 64.3% of small lesions (<10 mm), relative to 97.2% for larger lesions. Multivariate analysis also revealed that lesion size of <10 mm predicted a less accurate histopathological diagnosis (odds ratio: 6.97, 95% confidence interval: 1.02–47.67; p = 0.041). Further analyses revealed a failed histological diagnosis in 4 patients with lesions of <5 mm in size and accurate diagnoses in 9 out of 10 patients with lesions of 5–10 mm in size. Conclusions: The diagnostic accuracy for small lesions (<10 mm), especially for lesions of <5 mm, based on histological examination alone, was significantly lower than that for others (>10 mm). Furthermore, multivariate analysis revealed that only lesion size was an independent predictor of histopathological diagnosis accuracy. MDPI 2020-12-25 /pmc/articles/PMC7823918/ /pubmed/33375661 http://dx.doi.org/10.3390/diagnostics11010027 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Takahashi, Kosuke
Yasuda, Ichiro
Hanaoka, Tatsuyuki
Hayashi, Yuka
Araki, Yasuhiro
Motoo, Iori
Kajiura, Shinya
Ando, Takayuki
Fujinami, Haruka
Tajiri, Kazuto
Minemura, Masami
Takahara, Terumi
Diagnostic Fine-Needle Biopsy of Small Solid Pancreatic Lesions Using a Franseen Needle during Endoscopic Ultrasound Examination
title Diagnostic Fine-Needle Biopsy of Small Solid Pancreatic Lesions Using a Franseen Needle during Endoscopic Ultrasound Examination
title_full Diagnostic Fine-Needle Biopsy of Small Solid Pancreatic Lesions Using a Franseen Needle during Endoscopic Ultrasound Examination
title_fullStr Diagnostic Fine-Needle Biopsy of Small Solid Pancreatic Lesions Using a Franseen Needle during Endoscopic Ultrasound Examination
title_full_unstemmed Diagnostic Fine-Needle Biopsy of Small Solid Pancreatic Lesions Using a Franseen Needle during Endoscopic Ultrasound Examination
title_short Diagnostic Fine-Needle Biopsy of Small Solid Pancreatic Lesions Using a Franseen Needle during Endoscopic Ultrasound Examination
title_sort diagnostic fine-needle biopsy of small solid pancreatic lesions using a franseen needle during endoscopic ultrasound examination
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7823918/
https://www.ncbi.nlm.nih.gov/pubmed/33375661
http://dx.doi.org/10.3390/diagnostics11010027
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