A96 A QUALITY ASSESSMENT STUDY TO DETERMINE IF TISSUE ACQUISTION AND SPECIMEN HANDLING IMPACT THE DIAGNOSTIC YIELD OF ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION OF SOLID MASS

Journal of the Canadian Association of Gastroenterology Pub Date : 2024-02-14 DOI:10.1093/jcag/gwad061.096

S Khan, P. Mathura, L. Puttangunta, S. Girgis, J Zhang, J. Nilsson, S. Wesilenko

{"title":"A96 A QUALITY ASSESSMENT STUDY TO DETERMINE IF TISSUE ACQUISTION AND SPECIMEN HANDLING IMPACT THE DIAGNOSTIC YIELD OF ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION OF SOLID MASS","authors":"S Khan, P. Mathura, L. Puttangunta, S. Girgis, J Zhang, J. Nilsson, S. Wesilenko","doi":"10.1093/jcag/gwad061.096","DOIUrl":null,"url":null,"abstract":"Abstract Background Endoscopic ultrasound (EUS)-guided fine needle aspiration biopsy (FNAB) of solid mass lesions has a sensitivity and specificity between 50-100%. Tissue acquisition and specimen handling are factors that may contribute to this variability. At our institution, 3 endoscopists perform EUS. The aspirated material obtained is expressed onto slides for cytology (prepared by a nurse) and solid tissue fragments transferred into formalin. At the discretion of the endoscopist, aspirated material is collected in saline for cell block preparation. Aims To assess the impact of tissue collection and specimen handling on diagnostic yield of EUS-FNAB of solid mass lesions. Methods A chart audit was completed for all patients undergoing EUS-FNAB of solid mass lesions between January 1, 2022 and December 31, 2022. Descriptive statistics were completed. A definite diagnosis was considered when calculating the diagnostic yield. Results A total of 184 patients (100 M, 84 F), mean age 64±13 years (range 14-89 years), underwent 200 EUS-FNABs by 3 endoscopists. Pancreatic masses were the most common indication in 118/200 (59%) cases. A 22-gauge FNAB needle was used in 189/200 (95%) cases. A total of 285 needle passes were performed in 149 cases (mean 1.9/case). In the remaining 51 cases (26%), the number of needle passes was not specified. Tissue samples were transported in formalin in 190 cases, on cytology slides in 170 cases, and in saline for cell block preparation in 41 cases. Overall, a definite diagnosis was achieved in 149/200 cases (75%). Stratifying for needle passes, a definite diagnosis was achieved in 22/39 (56%), 71/85 (84%), 20/24 (83%), and 1/1 (100%) cases that had 1, 2, 3, and 4 needle passes. Of the 51 cases with unspecified needle passes, a definite diagnosis was achieved in 35 cases (69%). The diagnostic yield obtained with saline for cell block was similar to that obtained with formalin and cytology slides (30/41 [73%] vs. 144/190 [76%] and 132/170 [78%]). Conclusions Increasing the minimum number of needles passes for tissue acquisition to 3 per case may increase the diagnostic yield of EUS-FNAB. Documenting the number of needles passes in the endoscopy report is an important quality indicator. Cytology slides and tissue in formalin should be considered standard of care but aspirated material should continue to be used for cell block preparation. However, there is some concern that saline as a transport medium may de-vitalize the aspirated material, so it should be replaced with formalin to preserve tissue integrity. Funding Agencies None","PeriodicalId":508018,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"55 5","pages":"68 - 69"},"PeriodicalIF":0.0000,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Canadian Association of Gastroenterology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/jcag/gwad061.096","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

Abstract Background Endoscopic ultrasound (EUS)-guided fine needle aspiration biopsy (FNAB) of solid mass lesions has a sensitivity and specificity between 50-100%. Tissue acquisition and specimen handling are factors that may contribute to this variability. At our institution, 3 endoscopists perform EUS. The aspirated material obtained is expressed onto slides for cytology (prepared by a nurse) and solid tissue fragments transferred into formalin. At the discretion of the endoscopist, aspirated material is collected in saline for cell block preparation. Aims To assess the impact of tissue collection and specimen handling on diagnostic yield of EUS-FNAB of solid mass lesions. Methods A chart audit was completed for all patients undergoing EUS-FNAB of solid mass lesions between January 1, 2022 and December 31, 2022. Descriptive statistics were completed. A definite diagnosis was considered when calculating the diagnostic yield. Results A total of 184 patients (100 M, 84 F), mean age 64±13 years (range 14-89 years), underwent 200 EUS-FNABs by 3 endoscopists. Pancreatic masses were the most common indication in 118/200 (59%) cases. A 22-gauge FNAB needle was used in 189/200 (95%) cases. A total of 285 needle passes were performed in 149 cases (mean 1.9/case). In the remaining 51 cases (26%), the number of needle passes was not specified. Tissue samples were transported in formalin in 190 cases, on cytology slides in 170 cases, and in saline for cell block preparation in 41 cases. Overall, a definite diagnosis was achieved in 149/200 cases (75%). Stratifying for needle passes, a definite diagnosis was achieved in 22/39 (56%), 71/85 (84%), 20/24 (83%), and 1/1 (100%) cases that had 1, 2, 3, and 4 needle passes. Of the 51 cases with unspecified needle passes, a definite diagnosis was achieved in 35 cases (69%). The diagnostic yield obtained with saline for cell block was similar to that obtained with formalin and cytology slides (30/41 [73%] vs. 144/190 [76%] and 132/170 [78%]). Conclusions Increasing the minimum number of needles passes for tissue acquisition to 3 per case may increase the diagnostic yield of EUS-FNAB. Documenting the number of needles passes in the endoscopy report is an important quality indicator. Cytology slides and tissue in formalin should be considered standard of care but aspirated material should continue to be used for cell block preparation. However, there is some concern that saline as a transport medium may de-vitalize the aspirated material, so it should be replaced with formalin to preserve tissue integrity. Funding Agencies None

查看原文本刊更多论文

A96 一项质量评估研究，以确定组织采集和标本处理是否会影响内窥镜超声引导下实体肿块细针穿刺的诊断率

摘要背景内窥镜超声（EUS）引导下的实体肿块病变细针穿刺活检（FNAB）的敏感性和特异性在 50-100% 之间。组织采集和标本处理可能是造成这种差异的因素。在我院，由 3 名内镜医师执行 EUS。抽吸出的样本会在细胞学载玻片上显示（由护士准备），固体组织碎片会转移到福尔马林中。根据内镜医师的决定，将吸出的材料收集在生理盐水中，用于细胞块制备。目的评估组织收集和标本处理对 EUS-FNAB 诊断实性肿块病变产量的影响。方法对 2022 年 1 月 1 日至 2022 年 12 月 31 日期间接受 EUS-FNAB 诊断实性肿块病变的所有患者进行病历审核。完成了描述性统计。计算诊断率时考虑明确诊断。结果共有184名患者（100名男性，84名女性），平均年龄为64±13岁（14-89岁），由3名内镜医师进行了200例EUS-FNAB检查。在 118/200 例（59%）病例中，胰腺肿块是最常见的适应症。在 189/200 例（95%）病例中使用了 22 号 FNAB 针。在 149 例病例中，共进行了 285 次穿刺（平均每例 1.9 次）。其余 51 个病例（26%）未说明针刺次数。组织样本在福尔马林中保存的有 190 例，在细胞学切片中保存的有 170 例，在生理盐水中用于细胞块制备的有 41 例。总体而言，149/200 例（75%）获得了明确诊断。根据穿刺针次进行分层，分别有 22/39 例（56%）、71/85 例（84%）、20/24 例（83%）和 1/1 例（100%）穿刺针 1 次、2 次、3 次和 4 次的病例获得了明确诊断。在 51 例未明确针刺次数的病例中，有 35 例（69%）获得了明确诊断。使用生理盐水进行细胞阻滞的诊断率与使用福尔马林和细胞学切片的诊断率相似（30/41 [73%] vs. 144/190 [76%] and 132/170 [78%]）。结论将每例采集组织的最少针数增加到 3 次，可提高 EUS-FNAB 的诊断率。在内窥镜检查报告中记录针刺次数是一项重要的质量指标。细胞学切片和福尔马林中的组织应被视为标准护理，但吸出的材料应继续用于细胞块制备。不过，有人担心生理盐水作为运输介质可能会使吸出的材料失去活力，因此应该用福尔马林代替生理盐水，以保持组织的完整性。无

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of the Canadian Association of Gastroenterology

自引率

0.00%

发文量