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A prospective randomized study of the difference in diagnostic yield between endoscopic ultrasound-guided fine-needle aspiration (EUSFNA) needles with and without a side port in pancreatic masses.

Ang TL, Kwek AB, Seo DW, Paik WH, Cheng TY, Wang HP, Lau J - Endosc Int Open (2015)

Bottom Line: B: 25/30 vs. 26/30 (P = 0.718).B: 26/30 vs. 26/30 (P = 1.0).NCT02092519.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore.

ABSTRACT

Background and study aims: Two 22G needles with similar designs, apart from the absence (A) or presence of a side port (B), are available for endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA). The side port was designed to increase diagnostic yield but this advantage was unproven. This study evaluated the difference in diagnostic yield between both needles in pancreatic masses.

Patients and methods: This was a prospective multicenter randomized cross-over study. Patients with pancreatic masses were randomized to one needle for the first two passes, followed by the other for the next two passes. A pathologist blinded to the needle assessed each puncture for cellularity and morphology. The diagnostic yield between both needles was compared.

Results: In total, 30 patients were recruited (mean lesion size: 3.5 cm, range: 1.2 - 6.3). Comparison of cellularity adequacy: first pass: A vs. B: 26/30 vs. 24/30 (P = 0.488): 2nd pass: A vs. B: 25/30 vs. 26/30 (P = 0.718). Comparison of diagnostic accuracy: first pass: A vs. B: 22/30 vs. 23/30 (P = 0.766); after two passes: A vs. B: 26/30 vs. 26/30 (P = 1.0). When all four passes were assessed, adequate cellularity was obtained in 29/30 and the correct diagnosis was obtained in 28/30 patients. There were no procedural complications.

Conclusions: There was no significant difference in diagnostic yield between EUSFNA needles with or without a side port for pancreatic masses.

Study registration: NCT02092519.

No MeSH data available.


Related in: MedlinePlus

 Hematoxylin and eosin stain of cell block from pancreatic adenocarcinoma (× 200). a From needle without side port; b from needle with side port.
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FI192-3:  Hematoxylin and eosin stain of cell block from pancreatic adenocarcinoma (× 200). a From needle without side port; b from needle with side port.

Mentions: Assessment of cellular morphology was performed for each individual needle pass. The outcome for the individual first and second needle pass, as well as when both passes were combined, was compared between the two needles. Results are summarized in Table 2. In terms of diagnostic accuracy, there were no statistically significant differences between needles with or without side port (Fig. 2 a, b and Fig. 3 a, b) for the first pass (76.7 % vs. 73.3 %, P = 0.766) and when both needle passes were combined (86.7 % vs. 86.7 %, P = 1). When the four passes for each lesion were assessed together, the correct diagnosis was obtained in 24/24 cases of pancreatic adenocarcinoma, 1/2 neuroendocrine tumor, 2/2 pseudotumor, 1/1 serous cystadenoma and 0/1 case of cholangiocarcinoma, giving an overall diagnostic accuracy of 96.7 % (28/30).


A prospective randomized study of the difference in diagnostic yield between endoscopic ultrasound-guided fine-needle aspiration (EUSFNA) needles with and without a side port in pancreatic masses.

Ang TL, Kwek AB, Seo DW, Paik WH, Cheng TY, Wang HP, Lau J - Endosc Int Open (2015)

 Hematoxylin and eosin stain of cell block from pancreatic adenocarcinoma (× 200). a From needle without side port; b from needle with side port.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4554507&req=5

FI192-3:  Hematoxylin and eosin stain of cell block from pancreatic adenocarcinoma (× 200). a From needle without side port; b from needle with side port.
Mentions: Assessment of cellular morphology was performed for each individual needle pass. The outcome for the individual first and second needle pass, as well as when both passes were combined, was compared between the two needles. Results are summarized in Table 2. In terms of diagnostic accuracy, there were no statistically significant differences between needles with or without side port (Fig. 2 a, b and Fig. 3 a, b) for the first pass (76.7 % vs. 73.3 %, P = 0.766) and when both needle passes were combined (86.7 % vs. 86.7 %, P = 1). When the four passes for each lesion were assessed together, the correct diagnosis was obtained in 24/24 cases of pancreatic adenocarcinoma, 1/2 neuroendocrine tumor, 2/2 pseudotumor, 1/1 serous cystadenoma and 0/1 case of cholangiocarcinoma, giving an overall diagnostic accuracy of 96.7 % (28/30).

Bottom Line: B: 25/30 vs. 26/30 (P = 0.718).B: 26/30 vs. 26/30 (P = 1.0).NCT02092519.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore.

ABSTRACT

Background and study aims: Two 22G needles with similar designs, apart from the absence (A) or presence of a side port (B), are available for endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA). The side port was designed to increase diagnostic yield but this advantage was unproven. This study evaluated the difference in diagnostic yield between both needles in pancreatic masses.

Patients and methods: This was a prospective multicenter randomized cross-over study. Patients with pancreatic masses were randomized to one needle for the first two passes, followed by the other for the next two passes. A pathologist blinded to the needle assessed each puncture for cellularity and morphology. The diagnostic yield between both needles was compared.

Results: In total, 30 patients were recruited (mean lesion size: 3.5 cm, range: 1.2 - 6.3). Comparison of cellularity adequacy: first pass: A vs. B: 26/30 vs. 24/30 (P = 0.488): 2nd pass: A vs. B: 25/30 vs. 26/30 (P = 0.718). Comparison of diagnostic accuracy: first pass: A vs. B: 22/30 vs. 23/30 (P = 0.766); after two passes: A vs. B: 26/30 vs. 26/30 (P = 1.0). When all four passes were assessed, adequate cellularity was obtained in 29/30 and the correct diagnosis was obtained in 28/30 patients. There were no procedural complications.

Conclusions: There was no significant difference in diagnostic yield between EUSFNA needles with or without a side port for pancreatic masses.

Study registration: NCT02092519.

No MeSH data available.


Related in: MedlinePlus