Comparison between EUS-guided fine-needle aspiration cytology and EUS-guided fine-needle biopsy histology for the evaluation of pancreatic neuroendocrine tumors

被引：87

作者：

Crino, Stefano Francesco ^{[1
]}

Ammendola, Serena ^{[2
]}

Meneghetti, Anna ^{[1
]}

Bernardoni, Laura ^{[1
]}

Bellocchi, Maria Cristina Conti ^{[1
]}

Gabbrielli, Armando ^{[1
]}

Landoni, Luca ^{[3
]}

Paiella, Salvatore ^{[3
]}

Pin, Federico ^{[1
]}

Parisi, Alice ^{[2
]}

Mastrosimini, Maria Gaia ^{[2
]}

Amodio, Antonio ^{[1
]}

Frulloni, Luca ^{[1
]}

Facciorusso, Antonio ^{[4
]}

Larghi, Alberto ^{[5
]}

Manfrin, Erminia ^{[2
]}

机构：

[1] GB Rossi Univ Hosp, Pancreas Inst, Gastroenterol & Digest Endoscopy Unit, Verona, Italy

[2] GB Rossi Univ Hosp, Dept Diagnost & Publ Hlth, Verona, Italy

[3] Univ Verona Hosp Trust, Pancreas Inst, Dept Gen & Pancreat Surg, Verona, Italy

[4] Univ Foggia, Dept Med Sci, Digest Endoscopy Unit, Foggia, Italy

[5] IRCCS, Digest Endoscopy Unit, Fdn Policlin Univ A Gemelli, Rome, Italy

来源：

PANCREATOLOGY | 2021年 / 21卷 / 02期

关键词：

Ki-67 proliferative index; Pancreatic surgery; Small pNET; Endoscopic ultrasound tissue acquisition;

D O I：

10.1016/j.pan.2020.12.015

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background/objectives: Studies comparing EUS-guided fine-needle aspiration (EUS-FNA) with EUS-guided fine-needle biopsy (EUS-FNB) for the evaluation of pancreatic neuroendocrine tumors (pNETs) are lacking. We aimed at comparing EUS-FNA with EUS-FNB in terms of Ki-67 proliferative index (PI) estimation capability, cellularity of the samples, and reliability of Ki-67 PI/tumor grading compared with surgical specimens. Methods: Patients diagnosed with pNETs on EUS and/or surgical specimens were retrospectively identified. Specimens were re-evaluated to assess Ki-67 PI feasibility, sample cellularity by manual counting, and determination of Ki-67 PI value. Outcomes in the EUS-FNA and EUS-FNB groups were compared. Kendall rank test was used for Ki-67 PI correlation between EUS and surgical specimens. Subgroup analysis including small (<= 20 mm), non-functioning pNETs was performed. Results: Three-hundred samples from 292 lesions were evaluated: 69 EUS-FNA cytology and 231 EUS-FNB histology. Ki-67 PI feasibility was similar for EUS-FNA and EUS-FNB (91.3% vs. 95.7%, p = 0.15), while EUS-FNB performed significantly better in the subgroup of 179 small pNETs (88.2% vs. 96.1%, p = 0.04). Rate of poor cellulated (<500 cells) specimens was equal between EUS-FNA and EUS-FNB. A significant correlation for Ki-67 PI values between EUS and 92 correspondent surgical specimens was found in both groups, but it was stronger with EUS-FNB (tau = 0.626, p < 0.0001 vs. tau = 0.452, p = 0.031). Correct grading estimation was comparable between the two groups (p = 0.482). Conclusion: Our study showed stronger correlation for Ki-67 values between EUS-FNB and surgical specimens, and that EUS-FNB outperformed EUS-FNA in the evaluation of small pNETs. EUS-FNB should become standard of care for grading assessment of suspected pNETs. (C) 2020 IAP and EPC. Published by Elsevier B.V. All rights reserved.

引用

页码：443 / 450

页数：8

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