In:
Journal of Gastroenterology and Hepatology, Wiley, Vol. 37, No. 10 ( 2022-10), p. 1975-1982
Abstract:
Endoscopic ultrasound‐guided fine needle aspiration (EUS‐FNA) is the most established diagnostic method for pancreatic tissue. Rapid on‐site evaluation by a trained endoscopist (self‐ROSE) can improve the diagnostic accuracy. This research is aimed to analyze the application value of self‐ROSE for EUS‐FNA in solid pancreatic lesions. Methods A total of 194 consecutive patients with solid pancreatic lesions in Nanjing Drum Tower Hospital were randomized in a 1:1 ratio to EUS‐FNA with or without self‐ROSE in this single‐center randomized controlled trial. Before initiating self‐ROSE, the endoscopist underwent training for pancreatic cytologic sample adequacy assessment and cytopathological diagnosis of EUS‐FNA in pathology department for 1 month. Some parts of the slides of EUS‐FNA were air dried, stained on‐site with BASO Liu's reagent, and on‐site evaluated in self‐ROSE group. Between the two groups, the diagnostic performance of EUS‐FNA was analyzed, including sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, with a comparison of the number of needle passes and the complication rates. Results The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 94.8%, 94.4%, 100%, 100%, and 58.3% in the self‐ROSE group, respectively, and 70.1%, 65.1%, 100%, 100%, and 32.6% in the non‐self‐ROSE group. The diagnostic accuracy ( P 〈 0.001) and sensitivity ( P 〈 0.001) were both significantly increased during EUS‐FNA in the self‐ROSE group compared to the non‐self‐ROSE group. The rate of cytologic sample adequacy was 100% in self‐ROSE group and 80.4% in non‐self‐ROSE group. The number of passes were 3.38 ± 1.00 in self‐ROSE group and 3.22 ± 0.89 in non‐self‐ROSE group ( P = 0.228). No complications were found in both. There was acceptable consistency between endoscopist and pathologist in the cytopathological diagnosis (kappa = 0.666, P 〈 0.05) and in the sample adequacy rate (kappa = 1.000, P 〈 0.001). Conclusion Our results demonstrated that self‐ROSE is valuable for EUS‐FNA in the diagnosis of solid pancreatic lesions and is an important choice to routinely increase the accuracy of EUS‐FNA in centers without ROSE assessment.
Type of Medium:
Online Resource
ISSN:
0815-9319
,
1440-1746
Language:
English
Publisher:
Wiley
Publication Date:
2022
detail.hit.zdb_id:
2006782-3
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