Thomas Titus, Bebb James, Mannath Jayan, Ragunath Krish, Kaye Phillip V, Aithal Guruprasad P
Biomedical Research Unit, Nottingham Digestive Diseases Centre and Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.
JOP. 2010 Mar 5;11(2):163-9.
Fluid analysis obtained by EUS guided FNA is used to aid in diagnosis and management of cystic lesions in the pancreas. Complementing fluid aspiration with brushing of cyst wall may increase the cellular yield.
To compare cellular yield of pancreatic cyst FNA with and without wall brushing.
Comparative study.
Tertiary referral centre.
Fifty-one patients with cystic pancreatic lesions referred for EUS-guided aspiration/sampling were included (median age 69 years; interquartile range: 49-77 years).
Comparing adequacy of cellular yield between EUS-guided aspiration alone vs. EUS-guided aspiration and cyst wall brushing.
EUS-guided FNA and/or wall brushing (aspiration only: No. 27; brushing: No. 24).
There was no significant difference in age (P=0.496) cyst size (P=0.084) or cyst location (P=0.227) between groups. Overall 29.5%; (15/51) of samples were acellular/insufficient with no significant difference between the two groups (22.2% in the aspiration only group vs. 37.5% in the brushing group; P=0.356). The remaining samples were adequate for cytological evaluation (77.8% vs. 62.5%; aspiration only vs. brushing groups). Seventeen cases were neoplastic (8 benign, 9 malignant). The diagnostic accuracy was 61.9% and 55.0% in aspiration only and brushing groups, respectively. Two out of 4 (50.0%) patents were diagnosed as having cancer in the brushings group compared to 1/5 (20.0%) in the FNA only group (P=0.524).
Non-randomised series.
The cellular yield was similar in FNA and brushing group. Greater proportion of patients with malignant cystic pancreatic lesions diagnosed by EUS sampling was in the brushing group, but this did not reach statistical significance.
超声内镜引导下细针穿刺获取的液体分析有助于胰腺囊性病变的诊断和管理。通过刷取囊肿壁来辅助液体抽吸可能会增加细胞产量。
比较胰腺囊肿细针穿刺在有和没有刷取囊肿壁情况下的细胞产量。
对比研究。
三级转诊中心。
纳入51例因超声内镜引导下抽吸/采样而转诊的胰腺囊性病变患者（中位年龄69岁；四分位间距：49 - 77岁）。
比较单纯超声内镜引导下抽吸与超声内镜引导下抽吸并刷取囊肿壁之间细胞产量的充足性。
超声内镜引导下细针穿刺和/或刷取囊肿壁（仅抽吸：27号；刷取：24号）。
两组之间在年龄（P = 0.496）、囊肿大小（P = 0.084）或囊肿位置（P = 0.227）方面无显著差异。总体而言，29.5%（15/51）的样本无细胞/不足，两组之间无显著差异（仅抽吸组为22.2%，刷取组为37.5%；P = 0.356）。其余样本足以进行细胞学评估（仅抽吸组与刷取组分别为77.8%和62.5%）。17例为肿瘤性病变（8例良性，9例恶性）。仅抽吸组和刷取组的诊断准确率分别为61.9%和55.0%。刷取组4例患者中有2例（50.0%）被诊断为癌症，而仅细针穿刺组为1/5（20.0%）（P = 0.524）。
非随机系列研究。
细针穿刺组和刷取组的细胞产量相似。通过超声内镜采样诊断出的胰腺恶性囊性病变患者中，刷取组的比例更高，但未达到统计学意义。
