Combination of EUS-FNA and elastography (strain ratio) to exclude malignant solid pancreatic lesions: A prospective single-blinded study

被引:46
作者
Kongkam, Pradermchai [1 ,4 ]
Lakananurak, Narisorn [1 ]
Navicharern, Patpong [2 ]
Chantarojanasiri, Tanyaporn [1 ,5 ]
Aye, Khin [1 ]
Ridtitid, Wiriyaporn [1 ]
Kritisin, Krit
Angsuwatcharakon, Phonthep [1 ]
Aniwan, Satimai [1 ]
Pittayanon, Rapat [1 ]
Sampatanukul, Pichet [3 ]
Treeprasertsuk, Sombat [1 ]
Kullavanijaya, Pinit [1 ]
Rerknimitr, Rungsun [1 ]
机构
[1] Chulalongkorn Univ, Fac Med, Dept Med, Gastrointestinal Endoscopy Excellent Ctr, Bangkok 10330, Thailand
[2] Chulalongkorn Univ, Fac Med, Dept Surg, Bangkok 10330, Thailand
[3] Chulalongkorn Univ, Fac Med, Dept Pathol, Bangkok 10330, Thailand
[4] King Chulalongkorn Mem Hosp, Thai Red Cross Soc, Bangkok 10330, Thailand
[5] Police Gen Hosp, Dept Med, Bangkok, Thailand
关键词
cancer; elastography; endoscopic ultrasound; endosonography; EUS; EUS-FNA; fine needle aspiration; pancreas; pancreas neoplasm; solid pancreatic mass; ENDOSCOPIC ULTRASOUND ELASTOGRAPHY; GUIDED FNA; MASSES; DIAGNOSIS; RISK; SURVIVAL; CANCER;
D O I
10.1111/jgh.13067
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background:Negative results of EUS-FNA for solid pancreatic lesions (SPL) can be false ones. Combination with strain ratio (SR) may ensure a correct benign diagnosis of SPL. Aims:We prospectively evaluated the sensitivity rate of EUS-FNA and EUS elastography using the strain ratio method for diagnosing SPL. Methods:Thirty-eight patients with SPL identified by CT or MRI between January 2013 and November 2013 were included in our prospective study. EUS diagnoses were made using SR by an endosonographer who was blinded to all clinical information. In SPL with adequate cellularity, the results of EUS-FNA were combined with strain ratio to diagnose SPL and the diagnostic value was calculated. Results:Benign SPL were diagnosed in nine patients with surgical or guided-biopsy pathology (n=3) and benign cells from FNA with stable disease during the 12-month follow-up time (n=6). Using the best cut-off strain ratio level at 3.17, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy rate of EUS elastography were 86.2%, 66.7%, 89.3%, 60%, and 81.6%, respectively. For the 28 patients who underwent EUS-FNA with results of adequate cellularity; EUS-FNA alone versus combination of results of cytology and SR provided sensitivity, specificity, PPV, NPV, and accuracy rate at 90% versus 95.2, 100% versus 71.4%, 100% versus 90.9%, 80% versus 83.3, and 92.9% versus 89.3%, respectively. Conclusions:In this prospective single-blinded study, the negative results of both EUS-FNA and SR were more reliable to exclude malignant SPL. The sensitivity of EUS elastography by SR was not superior to EUS-FNA. (c) 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd
引用
收藏
页码:1683 / 1689
页数:7
相关论文
共 24 条
[1]   RISK OF PANCREATIC-CARCINOMA IN TROPICAL CALCIFYING PANCREATITIS - AN EPIDEMIOLOGIC-STUDY [J].
CHARI, ST ;
MOHAN, V ;
PITCHUMONI, CS ;
VISWANATHAN, M ;
MADANAGOPALAN, N ;
LOWENFELS, AB .
PANCREAS, 1994, 9 (01) :62-66
[2]   Aggressive Surgical Approach for Patients with T4 Gastric Carcinoma: Promise or Myth? [J].
Cheng, Chi-Tung ;
Tsai, Chun-Yi ;
Hsu, Jun-Te ;
Vinayak, Rohan ;
Liu, Keng-Hao ;
Yeh, Chun-Nan ;
Yeh, Ta-Sen ;
Hwang, Tsann-Long ;
Jan, Yi-Yin .
ANNALS OF SURGICAL ONCOLOGY, 2011, 18 (06) :1606-1614
[3]   Diagnostic accuracy of quantitative EUS elastography for discriminating malignant from benign solid pancreatic masses: a prospective, single-center study [J].
Dawwas, Muhammad F. ;
Taha, Hatim ;
Leeds, John S. ;
Nayar, Manu K. ;
Oppong, Kofi W. .
GASTROINTESTINAL ENDOSCOPY, 2012, 76 (05) :953-961
[4]   Prognostic Factors and Survival in 324 Patients with Pancreatic Endocrine Tumor Treated at a Single Institution [J].
Ekeblad, Sara ;
Skogseid, Britt ;
Dunder, Kristina ;
Oberg, Kjell ;
Eriksson, Barbro .
CLINICAL CANCER RESEARCH, 2008, 14 (23) :7798-7803
[5]   Frequency of major complications after EUS-guided FNA of solid pancreatic masses: a prospective evaluation [J].
Eloubeidi, MA ;
Tamhane, A ;
Varadarajulu, S ;
Wilcox, CM .
GASTROINTESTINAL ENDOSCOPY, 2006, 63 (04) :622-629
[6]   EUS-guided FNA of solid pancreatic masses: a learning curve with 300 consecutive procedures [J].
Eloubeidi, MA ;
Tamhane, A .
GASTROINTESTINAL ENDOSCOPY, 2005, 61 (06) :700-708
[7]  
Fritscher-Ravens A, 2002, AM J GASTROENTEROL, V97, P2768
[8]   Endoscopic Ultrasound Elastography [J].
Giovannini, Marc .
PANCREATOLOGY, 2011, 11 :34-39
[9]   Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: A multicenter study [J].
Giovannini, Marc ;
Thomas, Botelberge ;
Erwan, Bories ;
Christian, Pesenti ;
Fabrice, Caillol ;
Benjamin, Esterni ;
Genevieve, Monges ;
Paolo, Arcidiacono ;
Pierre, Deprez ;
Robert, Yeung ;
Walter, Schimclt ;
Hanz, Schrader ;
Carl, Szymanski ;
Christoph, Dietrich ;
Pierre, Eisendrath ;
Jean-Luc, Van Laethem ;
Jacques, Deviere ;
Peter, Vilmann ;
Andrian, Saftoiu .
WORLD JOURNAL OF GASTROENTEROLOGY, 2009, 15 (13) :1587-1593
[10]   Survival in Population-based Pancreatic Cancer Patients: San Francisco Bay Area, 1995-1999 [J].
Gong, Zhihong ;
Holly, Elizabeth A. ;
Bracci, Paige M. .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 2011, 174 (12) :1373-1381