TY - JOUR
T1 - Pancreatic tissue sampling guided by EUS, CT/US, and surgery
T2 - a comparison of sensitivity and specificity.
AU - Mallery, J. Shawn
AU - Centeno, Barbara A.
AU - Hahn, Peter F.
AU - Chang, Yu Chiao
AU - Warshaw, Andrew L.
AU - Brugge, William R.
N1 - Funding Information:
Supported in part by a grant from the American Digestive Health Foundation.
Funding Information:
J. Shawn Mallery, MD, was supported by an Olympus Fellowship Award.
PY - 2002/8
Y1 - 2002/8
N2 - BACKGROUND: Needle aspiration of the pancreas is performed to differentiate pancreatic malignancy, focal chronic pancreatitis, and metastasis to the pancreas. Biopsies may be directed by using EUS, CT, US, or surgery. This study retrospectively compared the accuracy of EUS-guided, CT/US-guided, and surgical tissue sampling of the pancreas over a 5-year period. METHODS: The records of patients undergoing pancreatic tissue sampling were reviewed for a final clinical diagnosis based on the results of cytology, histology, and clinical history. The sensitivity, specificity, and accuracy of each technique were calculated. RESULTS: One hundred forty-nine tissue samples (68 EUS-guided, 70 CT/US-guided, 11 surgical) from 128 patients were compared. There was no significant difference in accuracy rates for EUS (76.4%), CT/US (81.4%), and surgically guided (81.8%) specimens. EUS was used when masses were smaller (2.6 +/- 0.1 cm) as compared with CT/US (3.4 +/- 0.2 cm, p < 0.001) and surgery (2.9 +/- 0.4 cm, p = 0.49). In univariate analyses, factors associated with greater accuracy regardless of technique were as follows: (1) older age, (2) larger size of the mass, and (3) participation by a cytologist during the procedure. A subsequent multivariate logistic regression analysis, in which the examination of the effect of each factor controls for the effect of each of the other factors, found that only older age was a significant predictor of accuracy. CONCLUSION: EUS-guided tissue sampling of pancreatic masses is as accurate as CT/US-guided sampling and surgical biopsies.
AB - BACKGROUND: Needle aspiration of the pancreas is performed to differentiate pancreatic malignancy, focal chronic pancreatitis, and metastasis to the pancreas. Biopsies may be directed by using EUS, CT, US, or surgery. This study retrospectively compared the accuracy of EUS-guided, CT/US-guided, and surgical tissue sampling of the pancreas over a 5-year period. METHODS: The records of patients undergoing pancreatic tissue sampling were reviewed for a final clinical diagnosis based on the results of cytology, histology, and clinical history. The sensitivity, specificity, and accuracy of each technique were calculated. RESULTS: One hundred forty-nine tissue samples (68 EUS-guided, 70 CT/US-guided, 11 surgical) from 128 patients were compared. There was no significant difference in accuracy rates for EUS (76.4%), CT/US (81.4%), and surgically guided (81.8%) specimens. EUS was used when masses were smaller (2.6 +/- 0.1 cm) as compared with CT/US (3.4 +/- 0.2 cm, p < 0.001) and surgery (2.9 +/- 0.4 cm, p = 0.49). In univariate analyses, factors associated with greater accuracy regardless of technique were as follows: (1) older age, (2) larger size of the mass, and (3) participation by a cytologist during the procedure. A subsequent multivariate logistic regression analysis, in which the examination of the effect of each factor controls for the effect of each of the other factors, found that only older age was a significant predictor of accuracy. CONCLUSION: EUS-guided tissue sampling of pancreatic masses is as accurate as CT/US-guided sampling and surgical biopsies.
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U2 - 10.1016/S0016-5107(02)70181-8
DO - 10.1016/S0016-5107(02)70181-8
M3 - Article
C2 - 12145600
AN - SCOPUS:0036673269
SN - 0016-5107
VL - 56
SP - 218
EP - 224
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 2
ER -