EUS-FNA and ROSE in solid lesions of the pancreas; have the same diagnostic efficacy compared to pancreatic sites?

OBJECTIVE: Various techniques, needle types, and additional methods such as on-site pathological evaluation (ROSE) are used to increase the sensitivity of endoscopic ultrasound-fine needle aspiration (EUS-FNA), which is used in the diagnosis of pancreatic solid lesions. In this study, diagnosticity of the lesions according to the regions of the pancreas with EUS-FNA and ROSE performed with the slow pull technique using a 22 G needle will be evaluated.
METHODS: A total of 82 patients who underwent EUS-FNA between January 2, 2015, and March 14, 2020, were included in the study. General and clinical information of the patients were recorded retrospectively. The patients were diagnosed according to The Papanicolaou Society of Cytopathology System for Reporting Pancreaticobiliary Cytology Classification. If the diagnosis could not be made with EUS-FNA and ROSE, the diagnosis was made with alternative methods of surgery or percutaneous biopsy. Patients diagnosed as benign with EUS-FNA and ROSE were followed for at least 1 year and were accepted as benign.
RESULTS: The mean age of the patients was 63.2±10.5 years and 54 (69.6%) of them were male. The mean lesion size was 36.8 mm and the number of needle passes was 2.87. The overall sensitivity was 82.9% and the specificity was 100%. The sensitivity of EUS-FNA and ROSE in solid lesions in the head and body of the pancreas was higher than in lesions in the tail region (p=0.024).
CONCLUSION: EUS-FNA and ROSE are an effective method in the diagnosis of pancreatic solid lesions. The use of a 22 G needle may be more diagnostic in the head and body of the pancreas than in the tail region.

Pankreasýn Solid Lezyonlarýnda EUS-FNA ve ROSE; Pankreasýn Bölgelerine göre Karþýlaþtýrýldýðýnda Ayný Tanýsal Etkinlikte midir?

Giriþ/Amaç: Pankreatik solid lezyonlarýn tanýsýnda kullanýlan endoskopik ultrason-ince iðne aspirasyonu (EUS-FNA) nýn duyarlýlýðýný artýrmak için çeþitli teknikler, iðne tipleri ve yerinde patolojik deðerlendirme (ROSE) gibi ek yöntemler kullanýlmaktadýr. Bu çalýþmada 22 G iðne kullanýlarak yavaþ çekme tekniði ile yapýlan EUS-FNA ve ROSE un pankreasýn solid lezyonlarýnda, pankreas bölgelerine göre tanýsal sensivitesi deðerlendirilecektir.
Yöntem/Tasarým: 2 Ocak 2015 ile 14 Mart 2020 tarihleri arasýnda EUS-FNA yapýlan toplam 82 hasta çalýþmaya dahil edildi. Hastalarýn genel özellikleri ve klinik bilgileri retrospektif olarak kaydedildi. Hastalara The Papanicolaou Society of Cytopatology System for Reporting Pancreaticobiliary Cytology Sýnýflamasýna göre taný konuldu. EUS-FNA ve ROSE ile taný konulamadýysa, alternatif cerrahi yöntemler veya perkütan biyopsi ile taný koyuldu. EUS-FNA ve ROSE ile benign taný alan hastalar en az bir yýl takip edildi.
Bulgular: Hastalarýn yaþ ortalamasý 63,2 ±10,5 yýl olup 54'ü (%69,6) erkekti. Ortalama lezyon boyutu 36.8 mm ve iðne geçiþ sayýsý 2.87 idi. Genel sensivite %82.9 ve spesifite %100'dü. EUS-FNA ve ROSE un pankreasýn baþ ve gövdesindeki solid lezyonlarda sensivitesi kuyruk bölgesindeki lezyonlara göre daha yüksekti (p: 0.024).
Sonuç: EUS-FNA ve ROSE, pankreas solid lezyonlarýnýn tanýsýnda etkili bir yöntemdir. 22 G iðne kullanýmý, pankreasýn baþ ve gövdesinde kuyruk bölgesine göre daha tanýsal olabilir. (NCI-2022-4-3/R1)