Khoury Tawfik, Kadah Anas, Farraj Moaad, Barhoum Masaad, Livoff Alejandro, Mari Amir, Mahamid Mahmud, Sbeit Wisam
Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel.
Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.
Cytopathology. 2019 Sep;30(5):499-503. doi: 10.1111/cyt.12712. Epub 2019 May 21.
Our aim was to assess adequacy and diagnostic accuracy of endoscopic ultrasound-fine needle aspiration (EUS-FNA) specimens with or without rapid on-site evaluation (ROSE) from pancreatic, upper gastrointestinal tract (UGIT) and adjacent masses.
A retrospective cohort study based on patients' files who underwent EUS-FNA in Galilee Medical Center in a 4 years period. Number of needle passes, repeated EUS and ROSE effect on tissue adequacy and diagnostic accuracy were reported.
One-hundred sixty-one patients were included. Ninety-three patients (57.7%) underwent EUS-FNA without ROSE (group A) compared to 68 patients (42.3%) with ROSE (group B). The most common location was in the pancreas (55% in group A vs 81% in group B). Addition of ROSE yielded a significantly higher specimen adequacy (65% in group A vs 92.6% in group B (Chi-Square < 0.0001, OR 6.72, 95% CI 2.45-18.38). The matching rate (accuracy) between ROSE diagnosis and final histopathological diagnosis was noticed in 61 out of 68 patients (89.7%, 95% CI 0.7993-0.9576). The Kappa coefficient correlations of matching rate between ROSE and final histopathological diagnosis of all lesion and in pancreatic lesions were 0.7558, (95% CI 0.625-0.887) and 0.7814, (95% CI 0.639-0.924), respectively.
EUS-FNA with ROSE significantly improve specimen adequacy and was associated with high diagnostic accuracy.
我们的目的是评估经内镜超声引导下细针穿刺活检（EUS-FNA）标本在有或无快速现场评估（ROSE）情况下，对胰腺、上消化道（UGIT）及相邻肿物的取材充足性和诊断准确性。
一项回顾性队列研究，基于在加利利医疗中心4年间接受EUS-FNA的患者病历。报告穿刺针数、重复EUS以及ROSE对组织取材充足性和诊断准确性的影响。
纳入161例患者。93例患者（57.7%）接受了无ROSE的EUS-FNA（A组），68例患者（42.3%）接受了有ROSE的EUS-FNA（B组）。最常见的部位是胰腺（A组为55%，B组为81%）。增加ROSE显著提高了标本取材充足率（A组为65%，B组为92.6%（卡方检验<0.0001，OR 6.72，95%CI 2.45 - 18.38））。68例患者中有61例（89.7%，95%CI 0.7993 - 0.9576）的ROSE诊断与最终组织病理学诊断匹配率（准确性）较高。ROSE与所有病变及胰腺病变的最终组织病理学诊断匹配率的Kappa系数相关性分别为0.7558（95%CI 0.625 - 0.887）和0.7814（95%CI 0.639 - 0.924）。
带有ROSE的EUS-FNA显著提高了标本取材充足性，并具有较高的诊断准确性。
