Echobrush Versus Standard EUS-Guided FNA of Cystic Lesions of the Pancreas. Preliminary Experience
MD Lozano, JC Subtil, JI Echeveste, M Betes, FJ Alvarez-Cienfuegos, N Gomez, MA Idoate. University of Navarra, Pamplona, Spain
Background: Cystic lesions of the pancreas are being detected with increasing frequency. EUS-guided FNA (EUS-FNA) of cystic fluid and exfoliated cells is one of the most accurate method of diagnosis but still has limited sensitivity. A new, through-the-needle cytologic brush system (EchoBrush) has been approved for use during EUS evaluation of cystic lesions of the pancreas.
Design: Data from 105 EUS-FNA of pancreatic cystic were analyzed in order to compare the cytologic yield of EchoBrush compared with conventional EUS-FNA. An attending cytophatologist was present on site to assess specimen adequacy in all the cases. Diagnostic yield of both procedures, as well as EUS-FNA and EUS-EchoBrush related adverse events were recorded. Statistical analysis was performed with the SPSS 15.0 version.
Results: A total of 105 cystic lesions of the pancreas in 105 patients (37 men and 78 women, mean age of 62.7 ± 11.9 years) were included in the study. Mean size of lesions was 23.2 ± 18.6 cm. In 76 cases (72.4%) we obtain the samples through conventional EUS-FNA, whereas in 39 (37.1%) we used EchoBrush. Diagnostic material was obtained in 87.2% of cases using EchoBrush and in 68.3% with conventional EUS-FNA. Adequacy of the samples and diagnostic yield were higher using EchoBrush with p=0.028. There was not EUS-FNA either EUS-EchoBrush related complications.
Conclusions: This study suggests that cytological specimens from pancreatic cystic lesions obtained using EchoBrush at the time of EUS are superior to conventional EUS-FNA mainly because of the higher yield of epithelial cells. Larger studies are needed to compare both methods.
Tuesday, March 23, 2010 8:30 AM
Platform Session: Section F, Tuesday Morning