Year 2018 / Volume 110 / Number 8
Original
Endoscopic ultrasound cytologic brushing vs endoscopic ultrasound - fine needle aspiration for cytological diagnosis of cystic pancreatic lesions. A multicenter, randomized open-label trial

478-484

DOI: 10.17235/reed.2018.5449/2017

José Lariño-Noia, Daniel de la Iglesia, Julio Iglesias-García, Manuel Macías, Aurelio López Martín, María Luisa Legaz, Juan Vila, Antonio Reyes, Ihab Abdulkader, J. Enrique Domínguez-Muñoz,

Abstract
Introduction: the incidence of cystic pancreatic lesions (CPL) in the asymptomatic population is increasing. Achieving a preoperative diagnosis of CPL still remains a challenge. Objectives: to evaluate the diagnostic accuracy of the cytological diagnosis of CPL from samples obtained by cytology brush versus standard endoscopic ultrasound fine needle aspiration (EUS-FNA). Methods: a multicenter, randomized, open-label trial was performed of EUS-cytology brush (EUS-EB) versus EUS-FNA for the cytological diagnosis of CPL. Patients that underwent EUS-FNA with a CPL > 15 mm were included and randomized into two groups: group I, EUS-EB; group II, EUS-FNA. The final diagnosis was based on the histological evaluation of surgical specimens and clinical parameters, imaging and a five year follow-up in non-operated patients. The main outcome was the diagnostic accuracy of both methods. Secondary outcomes were the diagnostic adequacy of specimens and the rate of adverse events. Data were compared using the Chi-squared test. An intention to treat (ITT) and per-protocol (PP) analysis were performed. Results: sixty-five patients were included in the study, 31 in group I and 34 in group II. Three patients initially randomized to group I were changed to group II as it was impossible to obtain a sample using the brush. The mean size of the CPL was 28.2 mm (range 16-60 mm). The diagnostic accuracy of EUS-EB was not superior to EUS-FNA, neither in the ITT nor the PP analysis (44.8% vs 41.1%, p = 0.77 and 38.4% vs 45.9%, p = 0.55). Conclusions: EUS-EB does not improve the diagnostic accuracy of CPL in comparison with EUS-FNA.
Share Button
New comment
Comments
No comments for this article
References
[1] Laffan TA, Horton KM, Klein AP, et al. Prevalence of unsuspected pancreatic cysts on MDCT. AJR Am J Roentgenol 2008; 191: 802–7.
[2] Brugge WR, Lewandrowski K, Lee-Lewandrowski E, et al. Diagnosis of pancreatic cystic neoplasms: a report of the cooperative pancreatic cyst study. Gastroenterology 2004; 126: 1330–6.
[3] Samarasena JB, Nakai Y, Chang KJ. Endoscopic ultrasonography-guided fine-needle aspiration of pancreatic cystic lesions: a practical approach to diagnosis and management. Gastrointest Endosc Clin N Am 2012; 22: 169–85, vii.
[4] Thornton GD, McPhail MJW, Nayagam S, et al. Endoscopic ultrasound guided fine needle aspiration for the diagnosis of pancreatic cystic neoplasms: A meta-analysis. Pancreatology 2013; 13: 48–57.
[5] Sendino O, Fernández-Esparrach G, Solé M, et al. Endoscopic ultrasonography-guided brushing increases cellular diagnosis of pancreatic cysts: A prospective study. Dig Liver Dis 2010; 42: 877–81.
[6] Al-Haddad M, Raimondo M, Woodward T, et al. Safety and efficacy of cytology brushings versus standard FNA in evaluating cystic lesions of the pancreas: a pilot study. Gastrointest Endosc 2007; 65: 894–8.
[7] Lozano MD, Subtil JC, Miravalles TL, et al. EchoBrush may be superior to standard EUS-guided FNA in the evaluation of cystic lesions of the pancreas. Cancer Cytopathol 2011; 119: 209–214.
[8] Linder JD, Geenen JE, Catalano MF. Cyst fluid analysis obtained by EUS-guided FNA in the evaluation of discrete cystic neoplasms of the pancreas: a prospective single-center experience. Gastrointest Endosc 2006; 64: 697–702.
[9] Attasaranya S, Pais S, LeBlanc J, et al. Endoscopic ultrasound-guided fine needle aspiration and cyst fluid analysis for pancreatic cysts. JOP 2007; 8: 553–63.
[10] Moparty B, Logroño R, Nealon WH, et al. The role of endoscopic ultrasound and endoscopic ultrasound-guided fine-needle aspiration in distinguishing pancreatic cystic lesions. Diagn Cytopathol 2007; 35: 18–25.
[11] de Jong K, Poley J-W, van Hooft JE, et al. Endoscopic ultrasound-guided fine-needle aspiration of pancreatic cystic lesions provides inadequate material for cytology and laboratory analysis: initial results from a prospective study. Endoscopy 2011; 43: 585–90.
[12] Al-Haddad M, Gill KR, Raimondo M, et al. Safety and efficacy of cytology brushings versus standard fine-needle aspiration in evaluating cystic pancreatic lesions: a controlled study. Endoscopy 2010; 42: 127–32.
[13] Thomas T, Bebb J, Mannath J, et al. EUS-guided pancreatic cyst brushing: a comparative study in a tertiary referral centre. JOP 2010; 11: 163–9.
Related articles

Letter

Gastric schwannoma diagnosing gastric stromal tumor

DOI: 10.17235/reed.2023.9919/2023

Letter

Icteric syndrome secondary to polycystic liver disease

DOI: 10.17235/reed.2023.9590/2023

Digestive Diseases Image

Metastatic lesion of a choroidal melanoma located in the head of pancreas

DOI: 10.17235/reed.2022.8843/2022

Digestive Diseases Image

An unusual cause of a protuberant lesion of the gastric antrum

DOI: 10.17235/reed.2022.8771/2022

Digestive Diseases Image

Giant cystic hepatocarcinoma in the absence of cirrhosis

DOI: 10.17235/reed.2021.8313/2021

Digestive Diseases Image

Malignancy of intraductal papillary neoplasm of the bile duct

DOI: 10.17235/reed.2021.8193/2021

Digestive Diseases Image

Inflammatory pseudotumor-like follicular dendritic cell sarcoma of the liver

DOI: 10.17235/reed.2020.7602/2020

Letter

Mucinous cystadenoma arising from a pancreatic heterotopia

DOI: 10.17235/reed.2020.7486/2020

Letter

Cystic duct cyst: type VI in Todani’s classification

DOI: 10.17235/reed.2020.7249/2020

Letter

Giant pancreatic cystic lymphangioma

DOI: 10.17235/reed.2020.7003/2020

Editorial

Colorectal endoscopic submucosal dissection is here to stay

DOI: 10.17235/reed.2020.6960/2020

Editorial

Safe surgery for cystic tumors of the pancreas

DOI: 10.17235/reed.2019.6042/2018

Digestive Diseases Image

Pancreatic enzyme replacement for refractory multiple large pancreatic cysts

DOI: 10.17235/reed.2019.6030/2018

Editorial

Cyst wall brushing. Exploring the limits of cytology

DOI: 10.17235/reed.2018.5771/2018

Digestive Diseases Image

Todani Ic cystic dilatation of the bile duct

DOI: 10.17235/reed.2018.5609/2018

Letter to the Editor

Author´s reply: Cystic pancreatic neuroendocrine tumors. A diagnostic challenge

DOI: 10.17235/reed.2018.5415/2017

Letter to the Editor

Sternal cutaneous metastasis of hilar cholangiocarcinoma

DOI: 10.17235/reed.2017.4979/2017

Letter to the Editor

Pancreatic neuroendocrine tumors

DOI: 10.17235/reed.2017.4725/2016

Digestive Diseases Image

Cystic duct cyst lesions (type VI)

Letter to the Editor

Hemobilia related to cystic artery pseudoaneurysm as a cause of acute pancreatitis

DOI: 10.17235/reed.2017.4532/2016

Letter to the Editor

Sister Mary Joseph’s nodule as initial pancreatic cancer manifestation

DOI: 10.17235/reed.2016.4479/2016

Original

3D echoendoscopy and miniprobes for rectal cancer staging

DOI: 10.17235/reed.2018.4453/2016

Case Report

Hemobilia due to intracholecystic papillary neoplasm

DOI: 10.17235/reed.2016.4205/2016

Case Report

Mesenteric schwannoma: an unusual cause of abdominal mass

DOI: 10.17235/reed.2016.4202/2016

Letter to the Editor

Surgical management of appendiceal adenocarcinoid. Case report and literature review

DOI: 10.17235/reed.2016.4049/2015

Letter to the Editor

Mucinous hepatic cystic neoplasm: An uncommon cystic lesion in the liver

DOI: 10.17235/reed.2015.3698/2015

Letter to the Editor

Leiomyoma of the round ligament of the liver: Report of one case

DOI: 10.17235/reed.2015.3725/2014

Citation tools
Lariño-Noia J, de la Iglesia D, Iglesias-García J, Macías M, López Martín A, Legaz M, et all. Endoscopic ultrasound cytologic brushing vs endoscopic ultrasound - fine needle aspiration for cytological diagnosis of cystic pancreatic lesions. A multicenter, randomized open-label trial. 5449/2017


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1293 visits.
This article has been downloaded 237 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 31/12/2017

Accepted: 18/02/2018

Online First: 12/04/2018

Published: 30/07/2018

Article revision time: 39 days

Article Online First time: 102 days

Article editing time: 211 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology