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Optimal Techniques for EUS-Guided Fine-Needle Aspiration of Pancreatic Solid Masses at Facilities without On-Site Cytopathology: Results from Two Prospective Randomised Trials

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Abstract
Background: EUS-guided fine-needle aspiration (EUS-FNA) has emerged as the primary modality for the cytologic diagnosis of pancreatic solid masses. The aim of this study is to determine whether technical factors including suction (S), non-suction (NS), capillary sampling with stylet slow-pull (CSSS), and the number of needle actuations (to-and-fro needle movements) may affect the accuracy of EUS-FNA for pancreatic solid masses at facilities without on-site cytopathology. Methods: The diagnostic yield of malignancy, blood contamination and cellularity at each sample acquired from EUS-FNA with or without S and different numbers of actuation (10, 15 and 20) were measured (study I). The optimal actuation number was determined and a head-to-head comparison trial between S and CSSS was performed (study II). Results: In study I, significant blood contamination was seen using S with 20 compared with 15 actuations (p = 0.002). Diagnostic yield of malignancy was not significantly different between 10, 15, and 20 actuations with S, whereas it was statistically higher for 15 actuations compared with 10 actuations with NS (p = 0.001). In study II, no difference was noted in diagnostic yield with 15 actuations between S and CSSS (88% vs. 90%, p = 0.74). Conclusions: Increasing actuation in NS resulted in a better diagnostic yield for EUS-FNA without significant blood contamination, whereas increasing actuation in S did not change the diagnostic yield of EUS-FNA while causing significant blood contamination. With 15 actuations, the diagnostic yield was comparable between S and CSSS.
Author(s)
백우현최준혁박양순이정복박도현
Issued Date
2021
Type
Article
Keyword
AccuracyBloodCellular biologyClinical trialsEndoscopyEUSfine-needle aspirationOnsitepancreatic neoplasmsuctionsuctioning
DOI
10.3390/jcm10204662
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8241
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_6510e9c2be7941dc8c3c370a4f2b2571&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Optimal%20Techniques%20for%20EUS-Guided%20Fine-Needle%20Aspiration%20of%20Pancreatic%20Solid%20Masses%20at%20Facilities%20without%20On-Site%20Cytopathology:%20Results%20from%20Two%20Prospective%20Randomised%20Trials&offset=0&pcAvailability=true
Publisher
JOURNAL OF CLINICAL MEDICINE
Location
미국
Language
영어
ISSN
2077-0383
Citation Volume
10
Citation Number
20
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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