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Utility of core biopsy with concurrent ROSE FNA in the diagnosis of pancreatic tumor‐does the biopsy add any diagnostic benefit?
Author(s) -
Yan Lei,
Ikemura Kenji,
Park JiWeon
Publication year - 2018
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.23870
Subject(s) - medicine , malignancy , endoscopic ultrasound , biopsy , fine needle aspiration , radiology , diagnostic accuracy , lesion , pathology
Background Endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) and endoscopic ultrasound‐guided core‐needle biopsy (EUS‐CNB) are widely used for diagnosis of pancreatic tumors. The aim of our study was to compare the diagnostic performance of ROSE EUS‐FNA and EUS‐CNB for diagnosis of pancreatic malignancy during the same EUS. Methods Patients who underwent both FNA and CNB during the same EUS for pancreatic solid lesion were reviewed retrospectively. Sample adequacy, diagnostic yield (defined as percentage of definitive diagnosis), sensitivity and specificity for malignancy were compared between FNA and CNB. Results A total of 48 patients with solid pancreatic lesions were evaluated. The proportions of adequate samples were 48/48 (100%) for FNA and 45/48 (93.7%) for core biopsy ( P = .24). The diagnostic yield was 42/48 (87.5%) and 33/48 (68.7%) for FNA and CNB respectively ( P = .046). The incremental increase in diagnostic yield by combining both methods was 2/48 (4%). The diagnostic yield for malignancy was 30/32 (93.7%) for FNA and 23/32 (71.8%) for CNB ( P = .043). The sensitivity for the diagnosis of malignancy for FNA and CNB were 90.6% and 69%, respectively ( P = .045). The specificity was 100% for both methods. The sensitivity for diagnosing malignancy increased to 93.8% when the two methods were combined. The difference in diagnostic yield was not associated with lesion size or location. Conclusion EUS‐guided FNA is a superior method of assessing solid pancreatic lesion and pancreatic malignancy with better diagnostic yield and higher sensitivity than EUS‐CNB.