Abstract：
BACKGROUND: Endoscopic ultrasound (EUS)-guided tissue acquisition is the preferred modality for diagnosing pancreatic lesions and mediastinal and abdominal lymph nodes. Rapid on-site cytologic evaluation improves the diagnostic outcome of EUS-guided fine-needle aspiration (FNA) but is unavailable at many centers. Alternatively, macroscopic on-site evaluation (MOSE) may improve the diagnostic outcome of EUS-FNA, but data are limited. Hence, the present study was conducted to assess the efficacy of MOSE in improving adequacy and accuracy.
METHODS: We retrospectively analyzed data of consecutive patients with pancreatic or lymph nodal lesions undergoing EUS-guided FNA at a tertiary care center from December 2020 to December 2022. The study\'s primary outcomes were adequacy and diagnostic accuracy of the EUS-guided tissue acquisition, with secondary analysis of predictors of adequacy and accuracy.
RESULTS: Data from 124 patients (44.4% male, median age: 54 years) who underwent EUS-FNA were included in the present analysis. The presence of macroscopic visible core (MVC) on MOSE was reported in 93/124 (75%) cases. An adequate sample for histopathological or cytological examination was obtained in 110/124 (88.7%) cases, while the diagnostic accuracy was 85.5%. On multivariate analysis, the absence of MVC on MOSE was found to be the independent negative predictor of both adequacy (OR 0.092, 95% CI: 0.024-0.349) and accuracy (OR 0.175, 95% CI: 0.057-0.536).
CONCLUSIONS: The presence of MVC on MOSE can be an indicator of specimen adequacy and can improve the diagnostic yield of EUS-FNA.
METHODS: We retrospectively analyzed data of consecutive patients with pancreatic or lymph nodal lesions undergoing EUS-guided FNA at a tertiary care center from December 2020 to December 2022. The study\'s primary outcomes were adequacy and diagnostic accuracy of the EUS-guided tissue acquisition, with secondary analysis of predictors of adequacy and accuracy.
RESULTS: Data from 124 patients (44.4% male, median age: 54 years) who underwent EUS-FNA were included in the present analysis. The presence of macroscopic visible core (MVC) on MOSE was reported in 93/124 (75%) cases. An adequate sample for histopathological or cytological examination was obtained in 110/124 (88.7%) cases, while the diagnostic accuracy was 85.5%. On multivariate analysis, the absence of MVC on MOSE was found to be the independent negative predictor of both adequacy (OR 0.092, 95% CI: 0.024-0.349) and accuracy (OR 0.175, 95% CI: 0.057-0.536).
CONCLUSIONS: The presence of MVC on MOSE can be an indicator of specimen adequacy and can improve the diagnostic yield of EUS-FNA.
摘要：
背景：内镜超声（EUS）引导的组织采集是诊断胰腺病变以及纵隔和腹部淋巴结的首选方式。快速的现场细胞学评估可改善EUS引导的细针穿刺（FNA）的诊断结果，但在许多中心均不可用。或者，宏观现场评估（MOSE）可以改善EUS-FNA的诊断结果，但数据有限。因此，本研究旨在评估MOSE在改善充分性和准确性方面的功效.
方法：我们回顾性分析了2020年12月至2022年12月在三级护理中心接受EUS引导FNA的连续胰腺或淋巴结病变患者的数据。研究的主要结果是EUS引导的组织采集的充分性和诊断准确性，对充分性和准确性的预测因素进行二次分析。
结果：数据来自124例患者（44.4%为男性，中位年龄：54岁）接受EUS-FNA的患者被纳入本分析。据报道，在93/124例（75％）病例中，MOSE上存在宏观可见核心（MVC）。在110/124例（88.7％）病例中获得了足够的组织病理学或细胞学检查样本，而诊断准确率为85.5%。在多变量分析中，发现MOSE无MVC是充分性(OR0.092,95%CI:0.024-0.349)和准确性(OR0.175,95%CI:0.057-0.536)的独立负预测因子.
结论：MOSE上MVC的存在可以作为标本充分性的指标，并可以提高EUS-FNA的诊断率。
方法：我们回顾性分析了2020年12月至2022年12月在三级护理中心接受EUS引导FNA的连续胰腺或淋巴结病变患者的数据。研究的主要结果是EUS引导的组织采集的充分性和诊断准确性，对充分性和准确性的预测因素进行二次分析。
结果：数据来自124例患者（44.4%为男性，中位年龄：54岁）接受EUS-FNA的患者被纳入本分析。据报道，在93/124例（75％）病例中，MOSE上存在宏观可见核心（MVC）。在110/124例（88.7％）病例中获得了足够的组织病理学或细胞学检查样本，而诊断准确率为85.5%。在多变量分析中，发现MOSE无MVC是充分性(OR0.092,95%CI:0.024-0.349)和准确性(OR0.175,95%CI:0.057-0.536)的独立负预测因子.
结论：MOSE上MVC的存在可以作为标本充分性的指标，并可以提高EUS-FNA的诊断率。
