The additive diagnostic value of cytology in fine needle biopsy of pancreatic adenocarcinoma: A tertiary center experience

IF 1 4区医学 Q4 MEDICAL LABORATORY TECHNOLOGY Diagnostic Cytopathology Pub Date : 2024-06-25 DOI:10.1002/dc.25376

Wisam Sbeit MD, Amir Shahin MD, Maamoun Basheer MD, Tawfik Khoury MD

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Abstract

Objective

Endoscopic ultrasound guide fine needle biopsy (EUS-FNB) is the main diagnostic tool for pancreatic adenocarcinoma. In most instances, only histology is obtained via FNB, without sending cytological slides. The aim of our study was to assess the additive diagnostic yield of cytology performed through FNB.

Methods

We conducted a retrospective study of all patients with histological diagnosis of pancreatic adenocarcinoma who were diagnosed by EUS-FNB.

Results

Overall, 80 patients were included in the study period. The overall concordance between cytology and histology all FNB needles was 78.2%. Notably, cytological assessment improved the diagnostic yield for malignancy by 12.8%. The overall kappa coefficient correlation between histology and cytology was .501, 95% CI 0.361–0.641. However, the kappa correlation for suspicious of malignancy and malignant was excellent of .872, 95% CI 0.733–1, suggesting that cytology is crucial when histology is inconclusive. Further analysis showed that the Acquire and Sharkcore needles outperformed the Procore needle in term of concordance between cytology and histology (kappa correlation of .527, 95% CI 0.331–0.724, .515, 95% CI 0.265–0.764, and .297, 95% CI −0.051–0.646), respectively.

Conclusion

Performing cytology specimen when using FNB improves the diagnostic yield in pancreatic adenocarcinoma.

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细胞学在胰腺腺癌细针活检中的附加诊断价值：一家三级中心的经验。

目的：内镜超声引导细针活检（EUS-FNB）是胰腺腺癌的主要诊断工具。在大多数情况下，只通过细针活检获得组织学结果，而不发送细胞学切片。我们的研究旨在评估通过 FNB 进行细胞学检查的附加诊断率：我们对通过 EUS-FNB 诊断的所有胰腺腺癌组织学诊断患者进行了回顾性研究：研究期间共纳入 80 例患者。在所有 FNB 针中，细胞学与组织学的总体吻合率为 78.2%。值得注意的是，细胞学评估将恶性肿瘤的诊断率提高了12.8%。组织学与细胞学之间的总体卡帕系数相关性为0.501，95% CI为0.361-0.641。不过，恶性可疑和恶性的卡帕相关性非常好，为 0.872（95% CI 0.733-1），这表明当组织学无法得出结论时，细胞学至关重要。进一步分析表明，Acquire针和Sharkcore针在细胞学与组织学的一致性方面优于Procore针（kappa相关性分别为0.527，95% CI 0.331-0.724；0.515，95% CI 0.265-0.764；0.297，95% CI -0.051-0.646）：结论：使用 FNB 时进行细胞学标本检查可提高胰腺癌的诊断率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnostic Cytopathology 医学-病理学

CiteScore

2.60

自引率

7.70%

发文量

163

审稿时长

3-6 weeks

期刊介绍： Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.