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- Hedenström, PerGothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition (författare)
High clinical impact and diagnostic accuracy of EUS-guided biopsy sampling of subepithelial lesions: a prospective, comparative study.
- Artikel/kapitelEngelska2018
Förlag, utgivningsår, omfång ...
- 2017-08-15
- Springer Science and Business Media LLC,2018
Nummerbeteckningar
- LIBRIS-ID:oai:gup.ub.gu.se/270828
- https://gup.ub.gu.se/publication/270828URI
- https://doi.org/10.1007/s00464-017-5808-2DOI
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- Språk:engelska
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- In a tertiary center setting we aimed to study the diagnostic accuracy and clinical impact of EUS-guided biopsy sampling (EUS-FNB) with a reverse bevel needle compared with that of fine needle aspiration (EUS-FNA) in the work-up of subepithelial lesions (SEL).All patients presenting with SELs referred for EUS-guided sampling were prospectively included in 2012-2015. After randomization of the first pass modality, dual sampling with both EUS-FNB and EUS-FNA was performed in each lesion. Outcome measures in an intention-to-diagnose analysis were the diagnostic accuracy, technical failures, and adverse events. The clinical impact was measured as the performance of additional diagnostic procedures post-EUS and the rate of unwarranted resections compared with a reference cohort of SELs sampled in the same institution 2006-2011.In 70 dual sampling procedures of unique lesions (size: 6-220mm) the diagnostic sensitivity for malignancy and the overall accuracy of EUS-FNB was superior to EUS-FNA compared head-to-head (90 vs 52%, and 83 vs 49%, both p<0.001). The adverse event rate of EUS-FNB was low (1.2%). EUS-FNB in 2012-2015 had a positive clinical impact in comparison with the reference cohort demonstrated by less cases referred for an additional diagnostic procedure, 12/83 (14%) vs 39/73 (53%), p<0.001, and fewer unwarranted resections in cases subjected to surgery, 3/48 (6%) vs 12/35 (34%), p=0.001.EUS-FNB with a reverse bevel needle is safe and superior to EUS-FNA in providing a conclusive diagnosis of subepithelial lesions. This biopsy sampling approach facilitates a rational clinical management and accurate treatment.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
- Marschall, Hanns-Ulrich,1954 (författare)
- Nilsson, Bengt E,1949 (författare)
- Demif, Akir (författare)
- Lindkvist, Björn (författare)
- Nilsson, Ola,1957 (författare)
- Sadik, Riadh,1963 (författare)
- Göteborgs universitetInstitutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition (creator_code:org_t)
Sammanhörande titlar
- Ingår i:Surgical endoscopy: Springer Science and Business Media LLC32:3, s. 1304-13131432-22180930-2794
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