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DOI: 10.1055/s-0042-1744577
REPEATED EUS-GUIDED FINE NEEDLE BIOPSY AFTER NON-DIAGNOSTIC OR INCONCLUSIVE RESULTS OF SOLID PANCREATIC MASSES – THE REUBIO STUDY
Aims To evaluate the diagnostic yield of repeated EUS-FNB(rEUS-FNB) of pancreatic masses after previous non-diagnostic or inconclusive EUS-tissue acquisition(EUS-TA).
Methods A retrospective study retrieving consecutive patients who underwent rEUS-FNB for pancreatic masses at 26 Italian hospitals from July 2017 to July 2021 was conducted. Results are expressed in terms of odd ratio and 95%confidence intervals.
Results Three-hundred-42 patients were included(55.6% male, median age 69.5[60-76]); in 277(81%) cases a 2nd-generation EUS-FNB needle (fork-tip, Franseen-type or forward-bevel) was used, median 3[2-3] passes. ROSE was available in 63(18.4%) cases. Final diagnosis revealed malignancy in 255(74.6%) cases.
Repeated-EUS-FNB adequacy, sensitivity, specificity and accuracy were 91.1%, 91.2%, 91.1% and 90.5%, respectively. Positive and negative predictive values were 97.5% and 72.9%.
On univariate analysis, rEUS-FNB performed in high-volume centers (OR 2.79 [1.10-7.10])was related to sample adequacy while ROSE was not. On multivariate, the use of 2nd-generation EUS-FNB needles was the only variable independently related to sample adequacy (OR 4.40, 95% CI 0.10-1.40).
On univariate analysis, previous EUS-FNB was inversely related to accuracy (OR 0.38 [0.15-0.91]), while use of 2nd-generation EUS-FNB needles (OR 2.54 [1.25-5.18] was directly correlated; on multivariate analysis, the use of fork-tip needle (OR 11.57 [1.54-87.10]) and number of needle passes<3 (OR 0.50 [0.25-0.99]) were independently related to rEUS-FNB accuracy.
Conclusions Repeated-EUS-FNB showed optimal adequacy and accuracy after previous non-diagnostic or inconclusive EUS-TA of pancreatic masses.
Our data suggested that use of 2nd-generation EUS-FNB needles,>2 needle passes and patients referral to high-volume center may further increase sample adequacy and diagnostic accuracy.
Publication History
Article published online:
14 April 2022
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