Author(s): Wiersema MJ, Vilmann P, Giovannini M, Chang KJ, Wiersema LM
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Abstract BACKGROUND & AIMS: Endosonography-guided fine-needle aspiration biopsy (EUS-FNA) permits cytological confirmation of EUS findings. A multicenter prospective evaluation of EUS-FNA for primary diagnosis, staging, and/or follow-up purposes was undertaken. METHODS: EUS-FNA was performed in 457 patients with 554 lesions. Clinical (n = 218) or histopathologic (n = 256) confirmation was available in 192 lymph nodes, 145 extraluminal masses, 115 gastrointestinal wall lesions, and 22 cystic lesions. RESULTS: EUS-FNA sensitivity, specificity, and accuracy was 92\%, 93\%, and 92\% for lymph nodes, 88\%, 95\%, and 90\% for extraluminal masses, and 61\%, 79\%, and 67\% for gastrointestinal wall lesions, respectively. The sensitivity and accuracy for lymph nodes and extraluminal masses was superior to that for gastrointestinal wall lesions. When EUS-FNA was compared with EUS size criteria in lymph node evaluation, specificity (93\% vs. 24\%) and accuracy (92\% vs. 69\%) were superior, whereas sensitivity (92\% vs. 86\%) was similar. The accuracy of EUS-FNA in patients with previously failed biopsy procedures was 81\% (73 of 90). Five nonfatal complications occurred for a rate of 0.5\% (95\% confidence interval, 0.1\%-0.8\%) in solid lesions vs. 14\% (95\% confidence interval, 6\%-21\%) in cystic lesions. CONCLUSIONS: EUS-FNA accurately and safely evaluates solid peri-intestinal lesions and improves lymph node staging accuracy.
This article was published in Gastroenterology
and referenced in Journal of Gastrointestinal & Digestive System