Endoscopy 2019; 51(04): S45
DOI: 10.1055/s-0039-1681301
ESGE Days 2019 oral presentations
Friday, April 5, 2019 11:00 – 13:00: EUS diagnosis pancreas Club D
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION CYTOLOGY VS FINE NEEDLE BIOPSY FOR THE DIAGNOSIS OF PANCREATIC NEUROENDOCRINE TUMOURS

LH Eusebi
1   Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
2   HPB Endoscopy Unit, Royal Free Hospital, London, United Kingdom
,
D Thorburn
2   HPB Endoscopy Unit, Royal Free Hospital, London, United Kingdom
,
C Toumpanakis
3   Neuroendocrine Tumour Unit, Centre for Gastroenterology, Royal Free Hospital, London, United Kingdom
,
L Frazzoni
1   Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
,
G Johnson
4   Department of Gastroenterology, University College London Hospitals, London, United Kingdom
,
S Vessal
2   HPB Endoscopy Unit, Royal Free Hospital, London, United Kingdom
,
M Caplin
3   Neuroendocrine Tumour Unit, Centre for Gastroenterology, Royal Free Hospital, London, United Kingdom
,
SP Pereira
4   Department of Gastroenterology, University College London Hospitals, London, United Kingdom
5   Institute for Liver & Digestive Health, University College London, London, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) as a method of obtaining preoperative diagnosis of pancreatic neuroendocrine tumours (PNETs) has been reported in several series. Fine needle biopsies (FNB) are increasingly employed to obtain core specimens during EUS. However, the differences in efficacy between these sampling methods in the diagnosis of PNETs still needs to be defined.

Methods:

Over a 12-year period, all patients who underwent EUS-guided tissue sampling of suspicious pancreatic lesions identified by pancreatic protocol CT or MRI, with clinical, endoscopic and pathologic details were entered into an electronicdatabase. Lesions underwent EUS-FNA or FNB sampling, or a combination of the two, if feasible. The accuracy and safety of different EUS guided sampling methods for confirmed PNETs were investigated.

Results:

A total of 91 patients (M/F: 42/49, median age: 57 years, range: 26 – 87 years), who underwent a 102 EUS procedures, had a final diagnosis of PNET confirmed by histopathological examination as well as multidisciplinary review and clinical follow up. Preoperatively, both EUS-guided sampling modalities were used in 28 procedures, EUS-FNA alone was used in 61 cases, while EUS-FNB alone in 13 cases. The diagnostic yield of EUS-FNA and EUS-FNB alone, including the inadequate specimens, was 77.5% (95% CI: 68.9 – 86.2%) and 85.4% (95% CI: 74.6 – 96.2%), respectively. The combination of both sampling modalities established the diagnosis in 96.4% (95% CI: 89.6 – 100%) of cases (27/28), and was significantly superior to EUS-FNA alone. The diagnostic accuracy among the adequate samples for EUS-FNA, EUS-FNB and for the combination of the two methodswere 88.4% (95% CI: 80.9 – 96.0%), 94.3% (95% CI: 86.6 – 100%) and 100% (95% CI: 100 – 100%). There was one reported complication, a post-FNA bleeding, treated conservatively.

Conclusions:

EUS-FNB improves the diagnostic accuracy and confers additional information to cytological assessment of PNETs.