Document Detail


Rapid on-site evaluation by endosonographer during endoscopic ultrasound-guided fine needle aspiration for pancreatic solid masses.
MedLine Citation:
PMID:  23301574     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND AIM: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an established diagnostic method for patients with suspected pancreatic ductal carcinoma (PDC). Rapid on-site evaluation (ROSE) has been reported to improve the accuracy. However, an on-site cytopathologist is not routinely available in many institutions. One of the solutions may be ROSE by endosonographer. The aim was to examine whether diagnostic accuracy increases through ROSE by endosonographer using our cytological criteria. METHODS: Patients who underwent EUS-FNA of solid pancreatic masses from January 2006 until August 2009 (n=53, Period 1) and September 2009 to April 2011 (n=85, Period 2) were retrospectively identified. Before initiating ROSE at the start of period 2, two endosonographers underwent training for cytological interpretation, which was focused on four cytological features of PDC: anisonucleosis, nuclear membrane irregularity, overlapping, and enlargement. During EUS-FNA in period 2, endosonographers classified the Diff-Quik smears under three atypical grades and evaluated the adequacy. All diagnoses were made by one pathologist without knowledge of clinical information. RESULTS: The rate of "inconclusive" diagnoses, interpreted as "suspicious", "atypical" and "inadequate for diagnosis" was reduced from 26.4% in period 1 to 8.2% in period 2 (P=0.004). Moreover, diagnostic accuracy was increased from 69.2% in period 1 to 91.8% in period 2 (P<0.001). CONCLUSIONS: This cytological grading system used in ROSE by endosonographers is invaluable for diagnosis of pancreatic solid masses.
Authors:
Tsuyoshi Hayashi; Hirotoshi Ishiwatari; Makoto Yoshida; Michihiro Ono; Tsutomu Sato; Koji Miyanishi; Yasushi Sato; Masayoshi Kobune; Rishu Takimoto; Tomoko Mitsuhashi; Hiroko Asanuma; Jiro Ogino; Tadashi Hasegawa; Tomoko Sonoda; Junji Kato
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-10
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  -     ISSN:  1440-1746     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.
Affiliation:
Fourth Department of Internal Medicine, Sapporo Medical University School of Medicine.
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