Endoscopy 2020; 52(S 01): S320
DOI: 10.1055/s-0040-1705034
ESGE Days 2020 ePoster presentations
Thursday, April 23, 2020 09:00 – 17:00 Endoscopic ultrasound ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

COMPARISON OF LIQUID-BASED CYTOLOGY WITH CONVENTIONAL SMEAR CYTOLOGY FOR ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION OF SOLID PANCREATIC MASSES: PROSPECTIVE RANDOMIZED NON-INFERIORITY STUDY

YT Kim
1   Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea, Republic of
,
SH Lee
1   Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea, Republic of
,
YJ Hwang
2   Department of Pathology, Seoul National University Hospital, Seoul, Korea, Republic of
,
K Lee
2   Department of Pathology, Seoul National University Hospital, Seoul, Korea, Republic of
,
H Kim
2   Department of Pathology, Seoul National University Hospital, Seoul, Korea, Republic of
,
JW Chun
1   Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea, Republic of
,
WH Paik
1   Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea, Republic of
,
JK Ryu
1   Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims There is limited data on the efficacy of liquid-based cytology (LBC) for endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) specimens. We aimed to evaluate the diagnostic efficacy of LBC for solid pancreatic neoplasms compared to conventional smears (CS).

Methods In this randomized, crossover, non-inferiority trial, we randomly assigned (1:1) patients with suspected pancreatic cancer to either LBC or CS groups. Aspirates from the first needle pass were processed by one method, aspirates from the second pass by the other method, and specimens from the last pass were processed as core biopsies. The primary endpoint was the diagnostic efficacy of each method, with the final diagnosis as the gold standard. A non-inferiority margin of 10% was assumed. This trial is registered with ClinicalTrials.gov, number NCT03606148.

Results Of 170 randomized patients, 165 were classified as “malignant” and 5 as “benign”. Unsatisfactory samples were less frequent in LBC (1.78%) compared to CS (5.33%). The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of LBC versus CS were 88.0% versus 83.8% (P=.276), 87.7% versus 83.2% (P=.256), 100% versus 100% (P=.999), 100% versus 100% (P=.999), and 16.7% versus 16.1% (P=.953). When LBC was combined with core biopsy, the diagnostic accuracy was higher than that of LBC only (95.3% versus 88.0%, P=.016). A bloody background was significantly more frequent in CS (CS: 85.2%, LBC: 1.8%; P< 0.001), while the nuclear features were similar for both groups.

Conclusions The diagnostic utility of LBC was comparable to that of CS. The cytomorphologic features did not significantly differ between the two methods, and the reduced bloody backgrounds allowed better visibility in LBC method.