Document Detail


Histopathologic correlates of noncalcific chronic pancreatitis by EUS: a prospective tissue characterization study.
MedLine Citation:
PMID:  17640639     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Studies that correlated EUS features of chronic pancreatitis (CP) with histopathology are retrospective and only include patients with severe disease or calcific pancreatitis. Controversies regarding the significance of EUS features of noncalcific CP (NCCP) remain unresolved. OBJECTIVE: To correlate EUS criteria for NCCP with histology from surgical specimens. DESIGN: Prospective study. SETTING: Tertiary referral center. PATIENTS: All patients who underwent EUS for pancreaticobiliary indications and subsequent pancreatic surgery. Patients with calcific pancreatitis were excluded. METHODS: Individual CP features on EUS were carefully documented with relation to different parts of the pancreas. Standard EUS criteria for CP were adopted. All patients underwent surgery within 2 months of EUS. A single pathologist blinded to EUS findings reviewed the specimens and graded fibrosis (total score, 12; >or=6=unequivocal CP). A quantitative receiver operating characteristic (ROC) curve analysis was performed, and Spearman rank correlation coefficients were calculated. MAIN OUTCOME MEASUREMENTS: Correlate EUS criteria for NCCP, with histology from surgical specimens. RESULTS: Of the 42 patients evaluated, NCCP was diagnosed histologically in 21 patients (50%). None of the patients had CP diagnosis by CT. ROC curve analysis revealed that 4 or more EUS criteria provided the best sensitivity (90.5%), specificity (85.7%), and accuracy (88.1%) for diagnosing NCCP. Parenchymal EUS features that were significantly associated with histopathologic NCCP were foci (P<.0001), stranding (P<.001), and lobulations (P=.04); ductal features that were significantly associated with histopathologic NCCP were dilated (P<.0001) or irregular main pancreatic duct (P<.0001), side branches (P<.001), and hyperechoic duct margins (P=.03). There was a significant correlation between the number of EUS criteria and severity of NCCP on histology (r=0.85; P<.0001). LIMITATIONS: Small number of patients. CONCLUSIONS: An excellent correlation exists between EUS and histologic findings of NCCP.
Authors:
Shyam Varadarajulu; Isam Eltoum; Ashutosh Tamhane; Mohamad A Eloubeidi
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Publication Detail:
Type:  Journal Article     Date:  2007-07-20
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  66     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-29     Completed Date:  2007-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  501-9     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology-Hepatology, Department of Pathology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama 35294, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Endosonography*
Female
Fibrosis / pathology,  ultrasonography
Humans
Male
Middle Aged
Pancreas / pathology,  ultrasonography
Pancreatectomy
Pancreatitis, Chronic / pathology*,  surgery,  ultrasonography*
Prospective Studies
ROC Curve
Sensitivity and Specificity
Statistics as Topic
Comments/Corrections
Comment In:
Gastrointest Endosc. 2007 Sep;66(3):510-2   [PMID:  17725939 ]

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