Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis and grading of pancreatic neuroendocrine tumors: a retrospective analysis of 110 cases.
Endoscopy
; 52(11): 988-994, 2020 11.
Article
em En
| MEDLINE
| ID: mdl-32498099
ABSTRACT
BACKGROUND:
Data on the reliability of the Ki-67 index and grading calculations from endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic neuroendocrine tumors (PanNETs) are controversial. We aimed to assess the accuracy of these data compared with histology.METHODS:
Cytological analysis from EUS-FNA in patients with suspected PanNETs (nâ=â110) were compared with resection samples at a single institution. A minimum of 2000 cells were considered to be adequate for grading. Correlation and agreement between cytology and histology in grading and Ki-67 values, respectively, were investigated. Secondary outcomes included the diagnostic performance of EUS-FNA.RESULTS:
EUS-FNA samples were adequate for PanNET diagnosis and PanNET grading in 98/110 (89.1â%) and 77/110 (70.0â%) patients, respectively; thus, 77 samples were adequate for comparing cytology vs. histology. There were 67 (62.0â%), 40 (36.4â%), and 1 (0.9â%) patients with a final diagnosis of G1, G2, and G3 tumors, respectively. EUS-FNA grading was concordant with surgical pathology in 81.8â% of patients; under- and overgrading occurred in 15.6â% and 2.6â%, respectively. The overall level of agreement for grading was moderate (Cohen's κâ=â0.59, 95â% confidence interval [CI] 0.34â-â0.78). Spearman's rho for Ki-67 in tumors ≤â20âmm and >â20âmm was strong and moderate, respectively (rhoâ=â0.68, 95â%CI 0.47â-â0.83; rhoâ=â0.59, 95â%CI 0.35â-â0.75). The Blandâ-âAltman plot showed that the Ki-67 values were comparable and reproducible between the two measurements.CONCLUSIONS:
Although they were not available for a significant number of patients, grading and Ki-67 values from cytology correlated with histology moderately to strongly.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Pancreáticas
/
Tumores Neuroendócrinos
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article