Año 2018 / Volumen 110 / Número 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,

Resumen
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
Nuevo comentario
Comentarios
No hay comentarios para este artículo.
Bibliografía
[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.
Artículos relacionados

Carta

Gastric schwannoma diagnosing gastric stromal tumor

DOI: 10.17235/reed.2023.9919/2023

Carta

Sindrome ictérico secundario a poliquistosis hepática

DOI: 10.17235/reed.2023.9590/2023

Imagen en Patología Digestiva

Lesión metastásica en cabeza pancreática secundaria a melanoma de coroides

DOI: 10.17235/reed.2022.8843/2022

Imagen en Patología Digestiva

An unusual cause of a protuberant lesion of the gastric antrum

DOI: 10.17235/reed.2022.8771/2022

Imagen en Patología Digestiva

Hepatocarcinoma quístico gigante en ausencia de cirrosis

DOI: 10.17235/reed.2021.8313/2021

Imagen en Patología Digestiva

Malignización de neoplasia papilar intraductal de la vía biliar

DOI: 10.17235/reed.2021.8193/2021

Imagen en Patología Digestiva

Sarcoma de células dendríticas foliculares pseudotumor inflamatorio-like del hígado

DOI: 10.17235/reed.2020.7602/2020

Carta

Mucinous cystadenoma arising from a pancreatic heterotopia

DOI: 10.17235/reed.2020.7486/2020

Carta

Linfangioma quístico gigante pancreático

DOI: 10.17235/reed.2020.7003/2020

Imagen en Patología Digestiva

Intraductal papillary mucinous neoplasm of the biliary tract: a lesion of the bile duct lumen

DOI: 10.17235/reed.2019.6186/2019

Editorial

Safe surgery for cystic tumors of the pancreas

DOI: 10.17235/reed.2019.6042/2018

Imagen en Patología Digestiva

Pancreatic enzyme replacement for refractory multiple large pancreatic cysts

DOI: 10.17235/reed.2019.6030/2018

Imagen en Patología Digestiva

Dilatación quística de la vía biliar Todani Ic

DOI: 10.17235/reed.2018.5609/2018

Carta al Editor

Tumores neuroendocrinos quísticos del páncreas

DOI: 10.17235/reed.2017.5390/2017

Carta al Editor

Metástasis cutánea esternal de colangiocarcinoma hiliar

DOI: 10.17235/reed.2017.4979/2017

Carta al Editor

Tumores neuroendocrinos pancreáticos

DOI: 10.17235/reed.2017.4725/2016

Original

3D echoendoscopy and miniprobes for rectal cancer staging

DOI: 10.17235/reed.2018.4453/2016

Caso Clínico

Hemobilia por neoplasia papilar intracolecística

DOI: 10.17235/reed.2016.4205/2016

Caso Clínico

Mesenteric schwannoma: an unusual cause of abdominal mass

DOI: 10.17235/reed.2016.4202/2016

Carta al Editor

Leiomioma del ligamento redondo hepático: descripción de un caso

DOI: 10.17235/reed.2015.3725/2014

Instrucciones para citar
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


Descargar en un gestor de citas

Descargue la cita de este artículo haciendo clic en uno de los siguientes gestores de citas:

Métrica
Este artículo ha sido visitado 1622 veces.
Este artículo ha sido descargado 240 veces.

Estadísticas de Dimensions


Estadísticas de Plum Analytics

Ficha Técnica

Recibido: 31/12/2017

Aceptado: 18/02/2018

Prepublicado: 12/04/2018

Publicado: 30/07/2018

Tiempo de revisión del artículo: 39 días

Tiempo de prepublicación: 102 días

Tiempo de edición del artículo: 211 días


Compartir
Este artículo aun no tiene valoraciones.
Valoración del lector:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
La REED es el órgano oficial de la Sociedad Española de Patología Digestiva, la SociedadEspañola de Endoscopia Digestiva y la Asociación Española de Ecografía Digestiva
Política de cookies Política de Privacidad Aviso Legal © Copyright 2023 y Creative Commons. Revista Española de Enfermedades Digestivas