Endoscopic ultrasound with fine needle aspiration is useful in pancreatic cysts smaller than 3 cm

Faias, Sandra; Cravo, Marília; Silva, João Pereira da; Chaves, Paula; Pereira, António Dias

doi:10.1186/s12876-020-01565-9

Cited by 13 publications

(7 citation statements)

References 29 publications

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“…As shown in Figure 1, our initial query revealed 370 studies, being narrowed to 47 after careful selection of the abstracts, with 21 making the final cut for data extraction 14–34 . From these 21 papers, overall diagnostic accuracy data concerning only FNA or FNB were found in 13 and 14 studies, respectively.…”

Section: Resultsmentioning

confidence: 99%

Small biopsies for pancreatic lesions: Is there still room for fine needle aspiration?

Bueno,

Felipe‐Silva,

Saieg

2023

Cytopathology

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Pancreatic carcinoma is an aggressive tumour with increasing incidence in both sexes worldwide. Early detection is, therefore, essential for patient management. A recent advancement involves the utilization of larger, thicker gauge needles, which enable the collection of core‐type biopsies (FNB). Here, we investigated the role of fine needle aspiration and cytopathology in the diagnostic workflow of pancreatic lesions. A search query was designed to search for articles in the PubMed database comparing FNA and FNB for biopsy of pancreatic lesions, and detailed data were extracted from selected studies. Statistical analyses were performed using the R package meta version 6.2. Twenty‐one studies made the final cut for data extraction. Overall, median age was 64.3 years (±6.1; 47.6–71.5), male: female proportion 53.9 (±11.3; 27.6–67.4), lesion size 3.1 cm (±0.5; 1.9–4.2 cm) and percentage of malignant cases 78.3% (±26.8; 2.1–100). FNA and FNB diagnostic yield was 85.8% (±10.3; 70.0–100.0) and 89.2% (±7.7; 70.0–98.6), respectively. Average accuracy was 89.5% (±11.7; 63.0–100.0) for FNA and 90.8% (±7.1; 77.0–100.0) for FNB. Adverse effects rate was 1.0% (±1.3; 0–4.3) for FNA and 2.2% (±4.4; 0–16.1) for FNB. None of the selected variables had a significant statistical difference between both methods. FNA and FNB perform similarly for diagnostic material acquisition in pancreatic lesions. The best outcome comes from the association of both techniques, emphasizing the value of combining cytological and histological morphology for the most accurate analysis.

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Section: Resultsmentioning

confidence: 99%

Small biopsies for pancreatic lesions: Is there still room for fine needle aspiration?

Bueno,

Felipe‐Silva,

Saieg

2023

Cytopathology

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“…Endoscopic ultrasound (EUS) and EUS-guided the needle biopsy are useful in the management and diagnosis of pancreatic solid [ 19 ] or cystic lesions [ 20 – 22 ]. Li et al [ 23 ] reported that EUS with or without fine-needle aspiration had better performance in diagnosing pancreatic cystic neoplasms (PCNs) than CT or MRI.…”

Section: Discussionmentioning

confidence: 99%

Threshold of main pancreatic duct for malignancy in intraductal papillary mucinous neoplasm at head-neck and body-tail

Zhou

Wang

et al. 2022

BMC Gastroenterol

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Background Main pancreatic duct (MPD) dilation is a high-risk stigmata/worrisome feature of malignancy in intraductal papillary mucinous neoplasms (IPMNs). The threshold of MPD diameter in predicting malignancy may be related to the lesion location. This study aimed to separately identify the thresholds of MPD for malignancy of IPMNs separately for the head-neck and body-tail. Materials and methods A total of 185 patients with pathologically confirmed IPMNs were included. Patient demographic information, clinical data, and pathological features were obtained from the medical records. Those IPMNs with high-grade dysplasia or with associated invasive carcinoma were considered as malignant tumor. Radiological data including lesion location, tumor size, diameter of the MPD, mural nodule, and IPMN types (main duct, MD; branch duct, BD; and mixed type, MT), were collected on computed tomography or magnetic resonance imaging. Serum carbohydrate antigen 19-9 levels, serum carcinoembryonic antigen levels, and the medical history of diabetes mellitus, chronic cholecystitis, and pancreatitis were also collected. Results Malignant IPMNs were detected in 31.6% of 117 patients with lesions in the pancreatic head-neck and 20.9% of 67 patients with lesions in the pancreatic body-tail. In MPD-involved IPMNs, malignancy was observed in 54.1% of patients with lesions in the pancreatic head-neck and 30.8% of patients with lesions in the pancreatic body-tail (p < 0.05). The cutoff value of MPD diameter for malignancy was 6.5 mm for lesions in the head-neck and 7.7 mm for lesions in the body-tail in all type of IPMNs. In MPD-involved IPMNs, the threshold was 8.2 mm for lesion in pancreatic head-neck and 7.7 mm for lesions in the body-tail. Multivariate analysis confirmed that MPD diameter ≥ 6.5 mm (pancreatic head-neck) and MPD diameter ≥ 7.7 mm (pancreatic body-tail) were independent predictors of malignancy (p < 0.05). Similar results were observed in MPD-involved IPMNs using 8.2 mm as a threshold. Conclusion The thresholds of the dilated MPD may be associated with IPMNs locations. Thresholds of 6.5 mm for lesions in the head-neck and 7.7 mm for lesions in the body-tail were observed. For MPD-involved IPMNs alone, threshold for lesions in the head-neck was close to that in the body-tail.

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“…The 2017 revised Fukuoka guidelines proposed using a cyst size greater than 3 cm as a worrisome feature to recommend performing EUS-FNA 2 . The 2015 American Gastroenterological Association guidelines proposed cyst size greater than 3 cm as one of 3 high-risk features, along with dilation of the main pancreatic duct and the presence of a mass or nodule, which should prompt an EUS-FNA, but only if 2 of these features are present simultaneously 33,34 . Thus, measuring telomere length using EUS-FNA samples in the presence of cysts greater than 3 cm may be of value.…”

Section: Discussionmentioning

confidence: 99%

Telomere Attrition in Intraductal Papillary Mucinous Neoplasms of the Pancreas Associated With Carcinogenesis and Aging

Miki¹,

Matsuda

Aida

et al. 2022

Pancreas

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Objectives: It is challenging to preoperatively distinguish malignant and benign forms of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. The aims of this study were to investigate whether telomere length is associated with pathological grade of IPMNs and age and to clarify the utility of telomere length as a marker to identify malignant IPMNs.Methods: Pancreas tissue was obtained from 28 patients after resection.We measured the telomere lengths of tumor cells in IPMNs and normal duct cells by quantitative fluorescence in situ hybridization. The association of normalized telomere-centromere ratio (NTCR) to pathological grade of IPMNs and age were determined. Results:The NTCR showed a gradual decrease with increasing pathological grade of IPMNs. The NTCR in intermediate-and high-grade dysplasia and adenocarcinoma lesions was significantly shorter than in normal pancreatic ducts (P < 0.05). In multivariate analysis, telomere length was most associated with carcinogenesis. When the cutoff value of NTCR was set to 0.74, the sensitivity for detection of high-grade dysplasia and adenocarcinoma was 82.8%, with a specificity of 87.5%. Conclusions:Telomere shortening occurs with carcinogenesis and aging. A significant reduction of telomere length in IPMNs may be useful for surgical decision making.

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Endoscopic ultrasound with fine needle aspiration is useful in pancreatic cysts smaller than 3 cm

Cited by 13 publications

References 29 publications

Small biopsies for pancreatic lesions: Is there still room for fine needle aspiration?

Small biopsies for pancreatic lesions: Is there still room for fine needle aspiration?

Threshold of main pancreatic duct for malignancy in intraductal papillary mucinous neoplasm at head-neck and body-tail

Telomere Attrition in Intraductal Papillary Mucinous Neoplasms of the Pancreas Associated With Carcinogenesis and Aging

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