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Title: EUS-guided tissue acquisition in the study of the adrenal glands: Results of a nationwide multicenter study
Author: Martín Cardona, Albert
Fernández Esparrach, Gloria
Súbtil Íñigo, José Carlos
Iglesias García, Julio
García Guix, Marta
Barturen Barroso, Angel
Gimeno García, Antonio Z.
Esteban, José Miguel
Pardo Balteiro, Albert
Velasco Guardado, Antonio
Vazquez Sequeiros, Enrique
Loras Alastruey, Carme
Martínez Moreno, Belén
Castellot Martín, Ana
Huertas Nadal, Carlos
Martínez Lapiedra, Mamen
Sánchez Yague, Andrés
Teran, Álvaro
Morales Alvarado, Víctor J.
Betés Ibáñez, Maria Teresa
de la Iglesia, Daniel
Sánchez Montes, Cristina
Lozano Escario, María Dolores
Lariño Noia, José
Ginès, Àngels
Tebe, Cristian
Gornals Soler, Joan B.
Others: Universitat Oberta de Catalunya (UOC)
Keywords: Endoscopic ultrasonography
Issue Date: 6-Jun-2019
Publisher: PLoS ONE
Citation: Martín-Cardona, A., Fernández-Esparrach, G., Subtil, J.C., Iglesias-García, J., García-Guix, M., Barturen Barroso, A., Gimeno-García, A.Z., Esteban, J.M., Pardo Balteiro, A., Velasco-Guardado, A., Vazquez-Sequeiros, E., Loras, C., Martínez-Moreno, B., Castellot, A., Huertas, C., Martínez-Lapiedra, M., Sánchez-Yague, A., Teran, A., Morales-Alvarado, V.J., Betes, M., de la Iglesia, D., Sánchez-Montes, C., Lozano, M.D., Lariño-Noia, J., Gines, A., Tebe, C. & Gornals, J. (2019). EUS-guided tissue acquisition in the study of the adrenal glands: Results of a nationwide multicenter study. PLoS ONE, 14(6), 1-16. doi: 10.1371/journal.pone.0216658
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Abstract: Background: There are limited data about the role of endoscopic ultrasound-guided tissue acquisition (EUS-TA), by fine needle aspiration (EUS-FNA) or biopsy (EUS-FNB), in the evaluation of the adrenal glands (AG). The primary aim was to assess the diagnostic yield and safety. The secondary aims were the malignancy predictors, and to create a predictive model of malignancy. Methods: This was a retrospective nationwide study involving all Spanish hospitals experienced in EUS-TA of AGs. Inclusion period was from April-2003 to April-2016. Inclusion criteria: all consecutive cases that underwent EUS-TA of AGs. EUS and cytopathology findings were evaluated. Statistical analyses: diagnostic accuracy of echoendoscopist's suspicion using cytology by EUS-TA, as gold standard; multivariate logistic regression model to predict tumor malignancy. Results: A total of 204 EUS-TA of AGs were evaluated. Primary tumor locations were lung 70%, others 19%, and unknown 11%. AG samples were adequate for cytological diagnosis in 91%, and confirmed malignancy in 60%. Diagnostic accuracy of the endosonographer's suspicion was 68%. The most common technique was: a 22-G (65%) and cytological needle (75%) with suction-syringe (66%). No serious adverse events were described. The variables most associated with malignancy were size>30mm (OR2.27; 95%CI, 1.16-4.05), heterogeneous echo-pattern (OR2.11; 95%CI, 1.1-3.9), variegated AG shape (OR2.46; 95%CI, 1-6.24), and endosonographer suspicion (OR17.46; 95%CI, 6.2-58.5). The best variables for a predictive multivariate logistic model of malignancy were age, sex, echo-pattern, and AG-shape. Conclusions: EUS-TA of the AGs is a safe, minimally invasive procedure, allowing an excellent diagnostic yield. These results suggest the possibility of developing a pre-EUS procedure predictive malignancy model.
Language: English
ISSN: 1932-6203MIAR
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