한빛사 논문
울산대학교 의과대학
Song, Tae Jun MD1,4; Kim, Ji Hoon MD2,4; Lee, Sang Soo MD, PhD1; Eum, Jun Bum MD1; Moon, Sung Hoon MD1; Park, Do Hyun MD, PhD1; Seo, Dong Wan MD, PhD1; Lee, Sung Koo MD, PhD1; Jang, Se Jin MD, PhD2; Yun, Sung Cheol PhD3; Kim, Myung-Hwan MD, PhD1
1Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
2Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
3Department of Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
4These two authors contributed equally to this work
Correspondence: Sang Soo Lee, MD, PhD
Abstract
OBJECTIVES:
A large-caliber needle such as a 19-gauge needle may help overcome the limitations of a 22-gauge needle by acquiring a larger amount of tissue sample. However, there has been no well-designed comparative study for endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with a 19-gauge aspiration needle. We conducted this study to compare the diagnostic accuracy of EUS-FNA using a 19-gauge aspiration needle with that using a 22-gauge aspiration needle in patients with solid pancreatic/peripancreatic mass.
METHODS:
From March 2007 to April 2008, a total of 117 patients (60 in a 19-gauge needle group and 57 in a 22-gauge needle group) with solid pancreatic/peripancreatic mass were included. EUS-FNA was performed using the standard technique without an on-site cytopathologist. A single, blinded cytopathologist retrospectively evaluated each set of slides.
RESULTS:
The diagnostic accuracy by intention-to-treat analysis was not significantly different (19G: 86.7% vs. 22G: 78.9%,P=0.268). However, the diagnostic accuracy by per-protocol analysis, excluding technical failures, was significantly higher in the 19-gauge needle group (94.5% vs. 78.9%,P=0.015). In the treatment-received group that included crossover cases, although the diagnostic accuracy in all cases was not significantly different (86.1% vs. 76.9%,P=0.164), that of body/tail lesion (95.0% vs. 76.7%,P=0.031) and technically successful cases (93.9% vs. 78.1%,P=0.006) were significantly higher in the 19-gauge needle group. On sample quality analysis, the amount of cellular material obtained was significantly higher in the 19-gauge needle group (P=0.033).
CONCLUSIONS:
EUS-FNA with a 19-gauge aspiration needle may be a valuable method for the diagnosis of pancreatic/peripancreatic masses when an on-site cytopathologist is not available.
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