Endoscopic ultrasound‐guided fine‐needle aspiration for the diagnosis of solid pancreatic masses: the impact on patient‐management strategy
Summary Background Endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) is a safe and accurate technique for diagnosing pancreatic cancer. However, its impact for management of these patients is poorly investigated. Aims To investigate the diagnostic yield and the therapeutic impact of EU...
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| Veröffentlicht in: | Alimentary pharmacology & therapeutics 2009-11, Vol.30 (10), p.1070-1077 |
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| creator | TOUCHEFEU, Y. LE RHUN, M. CORON, E. ALAMDARI, A. HEYMANN, M. F. MOSNIER, J. F. MATYSIAK, T. GALMICHE, J. P. |
| description | Summary
Background Endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) is a safe and accurate technique for diagnosing pancreatic cancer. However, its impact for management of these patients is poorly investigated.
Aims To investigate the diagnostic yield and the therapeutic impact of EUS‐FNA in the management of solid pancreatic masses.
Methods One hundred consecutive patients who underwent EUS‐FNA for a solid pancreatic mass were included. Aspirates were placed onto glass slides for cytological examination and microbiopsies were fixed in formaldehyde for histology. The impact on clinical management was analysed retrospectively according to different endpoints, such as its impact on indications for chemotherapy, surgery or appropriate follow‐up modality.
Results Eight procedures were considered failures and two patients were lost to follow‐up. A final diagnosis was obtained in 90 patients. The sensitivity, specificity and accuracy of combined cytology and histology for the diagnosis of malignant or potentially‐malignant tumours were 78%, 75%, and 78% respectively. The sensitivity and accuracy of cytology alone were significantly higher than those of histology alone (P = 0.0003). By intention‐to‐diagnose analysis, EUS‐FNA directly influenced the management strategy in 62 of 100 patients.
Conclusions In patients with pancreatic mass and suspected malignancy, EUS‐FNA provides an accurate diagnosis in approximately 80% of cases. EUS‐FNA directly influences the management in two‐thirds of patients. |
| doi_str_mv | 10.1111/j.1365-2036.2009.04138.x |
| format | Article |
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Background Endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) is a safe and accurate technique for diagnosing pancreatic cancer. However, its impact for management of these patients is poorly investigated.
Aims To investigate the diagnostic yield and the therapeutic impact of EUS‐FNA in the management of solid pancreatic masses.
Methods One hundred consecutive patients who underwent EUS‐FNA for a solid pancreatic mass were included. Aspirates were placed onto glass slides for cytological examination and microbiopsies were fixed in formaldehyde for histology. The impact on clinical management was analysed retrospectively according to different endpoints, such as its impact on indications for chemotherapy, surgery or appropriate follow‐up modality.
Results Eight procedures were considered failures and two patients were lost to follow‐up. A final diagnosis was obtained in 90 patients. The sensitivity, specificity and accuracy of combined cytology and histology for the diagnosis of malignant or potentially‐malignant tumours were 78%, 75%, and 78% respectively. The sensitivity and accuracy of cytology alone were significantly higher than those of histology alone (P = 0.0003). By intention‐to‐diagnose analysis, EUS‐FNA directly influenced the management strategy in 62 of 100 patients.
Conclusions In patients with pancreatic mass and suspected malignancy, EUS‐FNA provides an accurate diagnosis in approximately 80% of cases. EUS‐FNA directly influences the management in two‐thirds of patients.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/j.1365-2036.2009.04138.x</identifier><identifier>PMID: 19735232</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Biopsy, Fine-Needle ; Diagnostic Errors ; Digestive system ; Endoscopy ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Medical sciences ; Middle Aged ; Pancreas - diagnostic imaging ; Pancreas - pathology ; Pancreatic Neoplasms - diagnosis ; Pancreatic Neoplasms - diagnostic imaging ; Pancreatic Neoplasms - pathology ; Pharmacology. Drug treatments ; Sensitivity and Specificity ; Ultrasonography</subject><ispartof>Alimentary pharmacology & therapeutics, 2009-11, Vol.30 (10), p.1070-1077</ispartof><rights>2009 Blackwell Publishing Ltd</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5458-8b4a23c130061300f19fa6dcf18350efc5d9a3253dc606829a994928a03065d33</citedby><cites>FETCH-LOGICAL-c5458-8b4a23c130061300f19fa6dcf18350efc5d9a3253dc606829a994928a03065d33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2036.2009.04138.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2036.2009.04138.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22044557$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19735232$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>TOUCHEFEU, Y.</creatorcontrib><creatorcontrib>LE RHUN, M.</creatorcontrib><creatorcontrib>CORON, E.</creatorcontrib><creatorcontrib>ALAMDARI, A.</creatorcontrib><creatorcontrib>HEYMANN, M. F.</creatorcontrib><creatorcontrib>MOSNIER, J. F.</creatorcontrib><creatorcontrib>MATYSIAK, T.</creatorcontrib><creatorcontrib>GALMICHE, J. P.</creatorcontrib><title>Endoscopic ultrasound‐guided fine‐needle aspiration for the diagnosis of solid pancreatic masses: the impact on patient‐management strategy</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background Endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) is a safe and accurate technique for diagnosing pancreatic cancer. However, its impact for management of these patients is poorly investigated.
Aims To investigate the diagnostic yield and the therapeutic impact of EUS‐FNA in the management of solid pancreatic masses.
Methods One hundred consecutive patients who underwent EUS‐FNA for a solid pancreatic mass were included. Aspirates were placed onto glass slides for cytological examination and microbiopsies were fixed in formaldehyde for histology. The impact on clinical management was analysed retrospectively according to different endpoints, such as its impact on indications for chemotherapy, surgery or appropriate follow‐up modality.
Results Eight procedures were considered failures and two patients were lost to follow‐up. A final diagnosis was obtained in 90 patients. The sensitivity, specificity and accuracy of combined cytology and histology for the diagnosis of malignant or potentially‐malignant tumours were 78%, 75%, and 78% respectively. The sensitivity and accuracy of cytology alone were significantly higher than those of histology alone (P = 0.0003). By intention‐to‐diagnose analysis, EUS‐FNA directly influenced the management strategy in 62 of 100 patients.
Conclusions In patients with pancreatic mass and suspected malignancy, EUS‐FNA provides an accurate diagnosis in approximately 80% of cases. EUS‐FNA directly influences the management in two‐thirds of patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Biopsy, Fine-Needle</subject><subject>Diagnostic Errors</subject><subject>Digestive system</subject><subject>Endoscopy</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pancreas - diagnostic imaging</subject><subject>Pancreas - pathology</subject><subject>Pancreatic Neoplasms - diagnosis</subject><subject>Pancreatic Neoplasms - diagnostic imaging</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Pharmacology. Drug treatments</subject><subject>Sensitivity and Specificity</subject><subject>Ultrasonography</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1u1DAQxyMEotvCKyBfgFOCP-LERuJQVS0gVYJDOVuuPxavEjt4EtG98QjwijwJTndVbggfbI_m958Z-19ViOCGlPVm1xDW8Zpi1jUUY9ngljDR3D2qNg-Jx9UG007WVBB2Up0C7DDGXY_p0-qEyJ5xyuim-nUZbQKTpmDQMsxZQ1qi_f3j53YJ1lnkQ3Qlis7ZwSENU8h6DikinzKavzpkg97GBAFQ8gjSECyadDTZFcygUQM4eHtPhnHSZkZFO5Wci3OpO-qot24sAYLSfHbb_bPqidcDuOfH86z6cnV5c_Ghvv70_uPF-XVteMtFLW5bTZkhrDxq3TyRXnfWeCIYx84bbqVmlDNrOtwJKrWUraRCY4Y7bhk7q14f6k45fVsczGoMYNww6OjSAqpnTAhJRF_IV_8kKSF9J1pcQHEATU4A2Xk15TDqvFcEq9U4tVOrP2r1R63GqXvj1F2Rvjj2WG5HZ_8Kj04V4OUR0GD04HP55AAPHKW4bTlfh3134L6Hwe3_ewB1_vlmvbE_6jC4tw</recordid><startdate>200911</startdate><enddate>200911</enddate><creator>TOUCHEFEU, Y.</creator><creator>LE RHUN, M.</creator><creator>CORON, E.</creator><creator>ALAMDARI, A.</creator><creator>HEYMANN, M. F.</creator><creator>MOSNIER, J. F.</creator><creator>MATYSIAK, T.</creator><creator>GALMICHE, J. P.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>200911</creationdate><title>Endoscopic ultrasound‐guided fine‐needle aspiration for the diagnosis of solid pancreatic masses: the impact on patient‐management strategy</title><author>TOUCHEFEU, Y. ; LE RHUN, M. ; CORON, E. ; ALAMDARI, A. ; HEYMANN, M. F. ; MOSNIER, J. F. ; MATYSIAK, T. ; GALMICHE, J. P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5458-8b4a23c130061300f19fa6dcf18350efc5d9a3253dc606829a994928a03065d33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Biopsy, Fine-Needle</topic><topic>Diagnostic Errors</topic><topic>Digestive system</topic><topic>Endoscopy</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pancreas - diagnostic imaging</topic><topic>Pancreas - pathology</topic><topic>Pancreatic Neoplasms - diagnosis</topic><topic>Pancreatic Neoplasms - diagnostic imaging</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Pharmacology. Drug treatments</topic><topic>Sensitivity and Specificity</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>TOUCHEFEU, Y.</creatorcontrib><creatorcontrib>LE RHUN, M.</creatorcontrib><creatorcontrib>CORON, E.</creatorcontrib><creatorcontrib>ALAMDARI, A.</creatorcontrib><creatorcontrib>HEYMANN, M. F.</creatorcontrib><creatorcontrib>MOSNIER, J. F.</creatorcontrib><creatorcontrib>MATYSIAK, T.</creatorcontrib><creatorcontrib>GALMICHE, J. P.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>TOUCHEFEU, Y.</au><au>LE RHUN, M.</au><au>CORON, E.</au><au>ALAMDARI, A.</au><au>HEYMANN, M. F.</au><au>MOSNIER, J. F.</au><au>MATYSIAK, T.</au><au>GALMICHE, J. P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endoscopic ultrasound‐guided fine‐needle aspiration for the diagnosis of solid pancreatic masses: the impact on patient‐management strategy</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2009-11</date><risdate>2009</risdate><volume>30</volume><issue>10</issue><spage>1070</spage><epage>1077</epage><pages>1070-1077</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><abstract>Summary
Background Endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) is a safe and accurate technique for diagnosing pancreatic cancer. However, its impact for management of these patients is poorly investigated.
Aims To investigate the diagnostic yield and the therapeutic impact of EUS‐FNA in the management of solid pancreatic masses.
Methods One hundred consecutive patients who underwent EUS‐FNA for a solid pancreatic mass were included. Aspirates were placed onto glass slides for cytological examination and microbiopsies were fixed in formaldehyde for histology. The impact on clinical management was analysed retrospectively according to different endpoints, such as its impact on indications for chemotherapy, surgery or appropriate follow‐up modality.
Results Eight procedures were considered failures and two patients were lost to follow‐up. A final diagnosis was obtained in 90 patients. The sensitivity, specificity and accuracy of combined cytology and histology for the diagnosis of malignant or potentially‐malignant tumours were 78%, 75%, and 78% respectively. The sensitivity and accuracy of cytology alone were significantly higher than those of histology alone (P = 0.0003). By intention‐to‐diagnose analysis, EUS‐FNA directly influenced the management strategy in 62 of 100 patients.
Conclusions In patients with pancreatic mass and suspected malignancy, EUS‐FNA provides an accurate diagnosis in approximately 80% of cases. EUS‐FNA directly influences the management in two‐thirds of patients.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>19735232</pmid><doi>10.1111/j.1365-2036.2009.04138.x</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Biopsy, Fine-Needle Diagnostic Errors Digestive system Endoscopy Gastroenterology. Liver. Pancreas. Abdomen Humans Medical sciences Middle Aged Pancreas - diagnostic imaging Pancreas - pathology Pancreatic Neoplasms - diagnosis Pancreatic Neoplasms - diagnostic imaging Pancreatic Neoplasms - pathology Pharmacology. Drug treatments Sensitivity and Specificity Ultrasonography |
| title | Endoscopic ultrasound‐guided fine‐needle aspiration for the diagnosis of solid pancreatic masses: the impact on patient‐management strategy |
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