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SHR Neuro Cancer Cardio Lipid Metab Microb

Savides, TJ; Donohue, M; Hunt, G; Al-Haddad, M; Aslanian, H; Ben-Menachem, T; Chen, VK; Coyle, W; Deutsch, J; DeWitt, J; Dhawan, M; Eckardt, A; Eloubeidi, M; Esker, A; Gordon, SR; Gress, F; Ikenberry, S; Joyce, AM; Klapman, J; Lo, S; Maluf-Fillho, F; Nickl, N; Singh, V; Wills, J; Behling, C.
EUS-guided FNA diagnostic yield of malignancy in solid pancreatic masses: a benchmark for quality performance measurement
GASTROINTEST ENDOSCOP. GASTROINTESTINAL ENDOSCOPY; 66: 277-282. ( Presented at: Digestive Disease Week Meeting/107th Annual Meeting of the American-Gastroenterological-Association, Los Angeles, CA, MAY 19-24, 2006) Doi: 10.1016/j.gie.2007.01.017
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Abstract:: BACKGROUND: The diagnostic yield of EUS-guided FNA (EUS-FNA) of solid pancreatic masses is a potential benchmark for EUS-FNA quality, because the majority of EUS-FNA of solid pancreatic masses should be diagnostic for malignancy. OBJECTIVES: To determine the cytologic diagnostic rate of malignancy in EUS-FNA of solid pancreatic masses and to determine if variability exists among endoscopists and centers. DESIGN: Multicenter retrospective study. PATIENTS: EUS centers provided cytology reports for all EUS-FNAs of solid, noncystic, >or=10-mm-diameter, solid pancreatic masses during a 1-year period. MAIN OUTCOME MEASUREMENT: Cytology diagnostic of pancreatic malignancy. RESULTS: A total of 1075 patients underwent EUS-FNA at 21 centers (81% academic) with 41 endoscopists. The median number of EUS-FNA of solid pancreatic masses performed during the year per center was 46 (range, 4-177) and per endoscopist was 19 (range, 1-97). The mean mass dimensions were 32 x 27 mm, with 73% located in the head. The mean number of passes was 3.5. Of the centers, 90% used immediate cytologic evaluation. The overall diagnostic rate of malignancy was 71%, 95% confidence interval 0.69%-0.74%, with 5% suspicious for malignancy, 6% atypical cells, and 18% negative for malignancy. The median diagnostic rate per center was 78% (range, 39%-93%; 1st quartile, 61%) and per endoscopist was 75% (range, 0%-100%; 1st quartile, 52%). LIMITATIONS: Retrospective study, participation bias, and varying chronic pancreatitis prevalence. CONCLUSIONS: (1) EUS-FNA cytology was diagnostic of malignancy in 71% of solid pancreatic masses and (2) endoscopists with a final cytologic diagnosis rate of malignancy for EUS-FNA of solid masses that was less than 52% were in the lowest quartile and should evaluate reasons for their low yield.
Find related publications in this database (using NLM MeSH Indexing): Adolescent -; Adult -; Aged -; Aged, 80 and over -; Biopsy, Fine-Needle -; Cytodiagnosis -; Endosonography -; Female -; Humans -; Male -; Middle Aged -; Pancreatic Neoplasms - diagnosis; Sensitivity and Specificity - diagnosis; Ultrasonography, Interventional - diagnosis