Small biopsies for pancreatic lesions: Is there still room for fine needle aspiration?

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Citações na Scopus
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Tipo de produção
article
Data de publicação
2024
DOI
Scopus
Web of Science
PubMed
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Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY
Autores
BUENO, Adriana
SAIEG, Mauro
Citação
CYTOPATHOLOGY, v.35, n.1, p.70-77, 2024
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Pancreatic carcinoma is an aggressive tumour with increasing incidence in both sexes worldwide. Early detection is, therefore, essential for patient management. A recent advancement involves the utilization of larger, thicker gauge needles, which enable the collection of core-type biopsies (FNB). Here, we investigated the role of fine needle aspiration and cytopathology in the diagnostic workflow of pancreatic lesions. A search query was designed to search for articles in the PubMed database comparing FNA and FNB for biopsy of pancreatic lesions, and detailed data were extracted from selected studies. Statistical analyses were performed using the R package meta version 6.2. Twenty-one studies made the final cut for data extraction. Overall, median age was 64.3 years (+/- 6.1; 47.6-71.5), male: female proportion 53.9 (+/- 11.3; 27.6-67.4), lesion size 3.1 cm (+/- 0.5; 1.9-4.2 cm) and percentage of malignant cases 78.3% (+/- 26.8; 2.1-100). FNA and FNB diagnostic yield was 85.8% (+/- 10.3; 70.0-100.0) and 89.2% (+/- 7.7; 70.0-98.6), respectively. Average accuracy was 89.5% (+/- 11.7; 63.0-100.0) for FNA and 90.8% (+/- 7.1; 77.0-100.0) for FNB. Adverse effects rate was 1.0% (+/- 1.3; 0-4.3) for FNA and 2.2% (+/- 4.4; 0-16.1) for FNB. None of the selected variables had a significant statistical difference between both methods. FNA and FNB perform similarly for diagnostic material acquisition in pancreatic lesions. The best outcome comes from the association of both techniques, emphasizing the value of combining cytological and histological morphology for the most accurate analysis. Much has been debated about the supposed advantages of FNB versus FNA sample acquisition for pancreatic lesions, with limited improvement in clinical parameters. According to our analysis, FNA and FNB perform similarly for diagnostic material acquisition in pancreatic lesions, with room for association of both techniques, emphasizing the value of combining cytological and histological morphology for the most accurate analysis.image
Palavras-chave
EUS, FNA, FNB, pancreatic lesion
URI
https://observatorio.fm.usp.br/handle/OPI/59029
Referências
  1. Adler DG, 2016, ENDOSC ULTRASOUND, V5, P178, DOI 10.4103/2303-9027.183976
  2. Arena M, 2017, MINERVA MED, V108, P547, DOI 10.23736/S0026-4806.17.05327-7
  3. Balduzzi S, 2019, EVID-BASED MENT HEAL, V22, P153, DOI 10.1136/ebmental-2019-300117
  4. Balsano R, 2023, CURR ONCOL, V30, P3871, DOI 10.3390/curroncol30040293
  5. Bang JY, 2021, CLIN GASTROENTEROL H, V19, P825, DOI 10.1016/j.cgh.2020.06.042
  6. Bang JY, 2018, GASTROINTEST ENDOSC, V87, P1432, DOI 10.1016/j.gie.2017.11.036
  7. Barresi L, 2018, DIGEST ENDOSC, V30, P760, DOI 10.1111/den.13197
  8. Chen TY, 2022, ENDOSC ULTRASOUND, V11, P393, DOI 10.4103/EUS-D-21-00163
  9. Chen YI, 2022, ENDOSCOPY, V54, P4, DOI 10.1055/a-1375-9775
  10. Cheng B, 2018, CLIN GASTROENTEROL H, V16, P1314, DOI 10.1016/j.cgh.2017.07.010
  11. Crinò SF, 2021, GASTROENTEROLOGY, V161, P899, DOI 10.1053/j.gastro.2021.06.005
  12. de Pretis N, 2021, DIAGNOSTICS, V11, DOI 10.3390/diagnostics11091653
  13. Du C, 2022, SURG ENDOSC, V36, P904, DOI 10.1007/s00464-021-08347-8
  14. Du C, 2017, WORLD J GASTROENTERO, V23, P5610, DOI 10.3748/wjg.v23.i30.5610
  15. Eloubeidi MA, 2006, GASTROINTEST ENDOSC, V63, P622, DOI 10.1016/j.gie.2005.05.024
  16. Fabbri C, 2017, SURG ENDOSC, V31, P225, DOI 10.1007/s00464-016-4960-4
  17. Facciorusso A, 2020, GASTROINTEST ENDOSC, V92, P1, DOI 10.1016/j.gie.2020.01.038
  18. Faias S, 2020, BMC GASTROENTEROL, V20, DOI 10.1186/s12876-020-01565-9
  19. Higgins JPT, 2002, STAT MED, V21, P1539, DOI 10.1002/sim.1186
  20. Higgins JPT., 2003, BMJ, V327, P557, DOI [DOI 10.1136/BMJ.327.7414.557, 10.1136/bmj.327.7414.557]
  21. Ishiwatari H, 2019, PANCREATOLOGY, V19, P191, DOI 10.1016/j.pan.2018.12.001
  22. Jiang HX, 2019, SCAND J GASTROENTERO, V54, P101, DOI 10.1080/00365521.2018.1564362
  23. Jin Ming, 2016, J Am Soc Cytopathol, V5, P286, DOI 10.1016/j.jasc.2016.03.002
  24. Kandel P, 2016, GASTROINTEST ENDOSC, V84, P1034, DOI 10.1016/j.gie.2016.03.1405
  25. Karsenti D, 2020, ENDOSCOPY, V52, P747, DOI 10.1055/a-1160-5485
  26. Kurita A, 2020, GASTROINTEST ENDOSC, V91, P373, DOI 10.1016/j.gie.2019.10.012
  27. McGuigan A, 2018, WORLD J GASTROENTERO, V24, P4846, DOI 10.3748/wjg.v24.i43.4846
  28. Minaga K, 2019, DIGEST DIS SCI, V64, P2982, DOI 10.1007/s10620-019-05624-4
  29. Mizukawa S, 2021, DIGEST DIS SCI, V66, P3171, DOI 10.1007/s10620-020-06628-1
  30. Nagai T, 2023, DIAGN CYTOPATHOL, V51, P467, DOI 10.1002/dc.25144
  31. Nakatsubo R, 2021, ENDOSC ULTRASOUND, V10, P207, DOI 10.4103/EUS-D-20-00174
  32. Naveed M, 2018, ENDOSC ULTRASOUND, V7, P34, DOI 10.4103/eus.eus_27_17
  33. Park SW, 2020, J GASTROEN HEPATOL, V35, P508, DOI 10.1111/jgh.14840
  34. Park SW, 2016, PLOS ONE, V11, DOI 10.1371/journal.pone.0154401
  35. Pitman MB, 2023, ACTA CYTOL, V67, P304, DOI 10.1159/000527912
  36. Puli SR, 2013, PANCREAS, V42, P20, DOI 10.1097/MPA.0b013e3182546e79
  37. Reid MD, 2015, MODERN PATHOL, V28, P686, DOI [10.1038/modpathol.2014.156, 10.1038/modpathol.2015.124]
  38. Saieg M, 2020, DIAGN CYTOPATHOL, V48, P494, DOI 10.1002/dc.24393
  39. Sundaram S, 2023, ANN GASTROENTEROL, V36, P340, DOI 10.20524/aog.2023.0790
  40. Sweeney J, 2020, DIAGN CYTOPATHOL, V48, P322, DOI 10.1002/dc.24377
  41. Syed A, 2019, DIAGN CYTOPATHOL, V47, P1138, DOI 10.1002/dc.24277
  42. Tarantino I, 2014, DIGEST LIVER DIS, V46, P41, DOI 10.1016/j.dld.2013.08.134
  43. Thomas T, 2009, AM J GASTROENTEROL, V104, P584, DOI 10.1038/ajg.2008.97
  44. Varadarajulu S, 2014, GASTROINTEST ENDOSC, V80, P1056, DOI 10.1016/j.gie.2014.05.304
  45. Wani S, 2015, AM J GASTROENTEROL, V110, P1429, DOI 10.1038/ajg.2015.262

Coleções
Artigos e Materiais de Revistas Científicas - FM/MPT