The usefulness of endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of pancreatic neuroendocrine tumors based on the World Health Organization classification
The usefulness of endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of pancreatic neuroendocrine tumors based on the World Health Organization classification
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DOI：
10.3109/00365521.2014.934909
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发表时间：
2014-11-01
影响因子：
1.9
通讯作者：
Shimosegawa, Tooru
中科院分区：
文献类型：
--
作者：
Unno, Jun;Kanno, Atsushi;Shimosegawa, Tooru
背景我们评估了在内镜超声引导下细针穿刺（EUS-FNA）中使用22号针诊断和评价胰腺神经内分泌肿瘤（pNET）Ki 67标记指数（Ki 67 LI）的争议话题。方法.本研究入组了38例在2008年1月1日至2012年12月31日期间接受EUS-FNA的pNET患者。当可用时，比较通过EUS-FNA和手术切除获得的Ki 67 LI和WHO分类。结果使用22 G针的EUS-FNA获得了足够的组织学样本，在35例（92.1%）中正确诊断pNET。19例病例的EUS-FNA和手术组织学标本均可用，根据基于Ki 67 LI的WHO分类，17例病例（89.5%）的2种手术分级一致。肿瘤大小与两种手术之间Ki 67 LI的差异相关，尽管对于小于18 mm的肿瘤，Ki 67 LI几乎完全一致。结论.使用22号针的EUS-FNA是诊断pNET的安全且高度准确的技术。EUS-FNA获得的组织学标本与手术获得的组织学标本之间存在明显的相关性。使用22号针头的EUS-FNA可用于预测pNET的WHO分类。
Background. We assessed the controversial topic of using 22-gauge needles in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for the diagnosis and evaluation of Ki67 labeling indices (Ki67LI) of pancreatic neuroendocrine tumors (pNET). Methods. Thirty-eight patients with pNET who underwent EUS-FNA between January 1, 2008 and December 31, 2012 were enrolled in this study. When available, the Ki67LI and WHO classifications obtained by EUS-FNA and surgical resection were compared. Results. EUS-FNA with a 22-gauge needle acquired sufficient histological sample to correctly diagnose pNET in 35 cases (92.1%). Both EUS-FNA and surgical histological specimens were available for 19 cases, and grading classes of the 2 procedures were consistent in 17 cases (89.5%) according to the WHO classification based on the Ki67LI. Tumor size was associated with a difference in the Ki67LI between the 2 procedures, although the Ki67LI was almost completely consistent for tumors less than 18 mm in size. Conclusions. EUS-FNA with a 22-gauge needle is a safe and highly accurate technique for the diagnosis of pNET. There was a clear correlation between the Ki67LI of histological specimens acquired by EUS-FNA and surgery. EUS-FNA with a 22-gauge needle is useful to predict the WHO classification of pNET.