Endoscopic ultrasound guided fine needle aspiration biopsy: a large single centre experience. Issue 5 (1st May 1999)

• Record Type: Journal Article
• Authors: Williams, D B; Sahai, A V; Aabakken, L; Penman, I D; van Velse, A; Webb, J; Wilson, M; Hoffman, B J; Hawes, R H
• Is Part Of: Gut. Volume 44:Issue 5(1999)
• Page Start: 720
• Page End: 726
• Publication Date: 1999-05-01
• Subjects: endoscopic ultrasound -- endosonography -- fine needle aspiration biopsy; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gut.44.5.720
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : BACKGROUND: Endoscopic ultrasound guided fine needle aspiration biopsy (EUS-FNA) is a recent innovation in the evaluation of gastrointestinal and pulmonary malignancies. AIMS: To review the experience with EUS-FNA of a large single centre. METHODS: 333 consecutive patients underwent EUS-FNA. Follow up data were available on 327 lesions in 317 patients, including 160 lymph nodes, 144 pancreatic lesions, 15 extraintestinal masses, and eight intramural tumours. RESULTS: A primary diagnosis of malignancy was obtained by EUS-FNA in 62% of patients with clinically suspicious lesions. The overall accuracy of EUS-FNA for the diagnosis of malignancy was 86%, with sensitivity of 84% and specificity of 96%. With respect to lesion types, the sensitivity, specificity, and accuracy were 85%, 100%, and 89% for lymph nodes; 82%, 100%, and 85% for pancreatic lesions; 88%, 100%, and 90% for perirectal masses; and 50%, 25%, and 38% for intramural lesions, respectively. Compared with size and sonographic criteria, EUS-FNA in the evaluation of lymph nodes provided superior accuracy and specificity, without compromising sensitivity. Inadequate specimens were obtained from only six patients, including 3/5 with stromal tumors. Only one complication occurred. CONCLUSIONS: EUS-FNA is safe and can readily obtain tissue specimens adequate for cytopathological diagnoses. Compared with size and sonographic criteria, it is a superior modality for the detection of nodal metastases. While providing accurate diagnosis of pancreatic and perirectal malignancies, results suggest the technique is less useful for intramural lesions.