Agreement on endoscopic ultrasonography-guided tissue specimens: Comparing a 20-G fine-needle biopsy to a 25-G fine-needle aspiration needle among academic and non-academic pathologists.
FNA
FNB
interobserver agreement
pathology
Journal
Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
ISSN: 1443-1661
Titre abrégé: Dig Endosc
Pays: Australia
ID NLM: 9101419
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
received:
17
01
2019
accepted:
17
04
2019
pubmed:
11
7
2019
medline:
4
9
2020
entrez:
11
7
2019
Statut:
ppublish
Résumé
A recently carried out randomized controlled trial showed the benefit of a novel 20-G fine-needle biopsy (FNB) over a 25-G fine-needle aspiration (FNA) needle. The current study evaluated the reproducibility of these findings among expert academic and non-academic pathologists. This study was a side-study of the ASPRO (ASpiration versus PROcore) study. Five centers retrieved 74 (59%) consecutive FNB and 51 (41%) FNA samples from the ASPRO study according to randomization; 64 (51%) pancreatic and 61 (49%) lymph node specimens. Samples were re-reviewed by five expert academic and five non-academic pathologists and rated in terms of sample quality and diagnosis. Ratings were compared between needles, expert academic and non-academic pathologists, target lesions, and cytology versus histological specimens. Besides a higher diagnostic accuracy, FNB also provided for a better agreement on diagnosing malignancy (ĸ = 0.59 vs ĸ = 0.76, P < 0.001) and classification according to Bethesda (ĸ = 0.45 vs ĸ = 0.61, P < 0.001). This equally applied for expert academic and non-academic pathologists and for pancreatic and lymph node specimens. Sample quality was also rated higher for FNB, but agreement ranged from poor (ĸ = 0.04) to fair (ĸ = 0.55). Histology provided better agreement than cytology, but only when a core specimen was obtained with FNB (P = 0.004 vs P = 0.432). This study shows that the 20-G FNB outperforms the 25-G FNA needle in terms of diagnostic agreement, independent of the background and experience of the pathologist. This endorses use of the 20-G FNB needle in both expert and lower volume EUS centers.
Sections du résumé
BACKGROUND AND AIM
OBJECTIVE
A recently carried out randomized controlled trial showed the benefit of a novel 20-G fine-needle biopsy (FNB) over a 25-G fine-needle aspiration (FNA) needle. The current study evaluated the reproducibility of these findings among expert academic and non-academic pathologists.
METHODS
METHODS
This study was a side-study of the ASPRO (ASpiration versus PROcore) study. Five centers retrieved 74 (59%) consecutive FNB and 51 (41%) FNA samples from the ASPRO study according to randomization; 64 (51%) pancreatic and 61 (49%) lymph node specimens. Samples were re-reviewed by five expert academic and five non-academic pathologists and rated in terms of sample quality and diagnosis. Ratings were compared between needles, expert academic and non-academic pathologists, target lesions, and cytology versus histological specimens.
RESULTS
RESULTS
Besides a higher diagnostic accuracy, FNB also provided for a better agreement on diagnosing malignancy (ĸ = 0.59 vs ĸ = 0.76, P < 0.001) and classification according to Bethesda (ĸ = 0.45 vs ĸ = 0.61, P < 0.001). This equally applied for expert academic and non-academic pathologists and for pancreatic and lymph node specimens. Sample quality was also rated higher for FNB, but agreement ranged from poor (ĸ = 0.04) to fair (ĸ = 0.55). Histology provided better agreement than cytology, but only when a core specimen was obtained with FNB (P = 0.004 vs P = 0.432).
CONCLUSION
CONCLUSIONS
This study shows that the 20-G FNB outperforms the 25-G FNA needle in terms of diagnostic agreement, independent of the background and experience of the pathologist. This endorses use of the 20-G FNB needle in both expert and lower volume EUS centers.
Identifiants
pubmed: 31290176
doi: 10.1111/den.13424
pmc: PMC6900144
doi:
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
690-697Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Organisme : Cook Medical Devices
ID : EUDRT05-09-2013
Informations de copyright
© 2019 The Authors. Digestive Endoscopy published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.
Références
Gastrointest Endosc. 2001 Apr;53(4):485-91
pubmed: 11275890
Sci Rep. 2016 Mar 10;6:22978
pubmed: 26960914
Am J Gastroenterol. 2011 Sep;106(9):1705-10
pubmed: 21483464
Endoscopy. 2012 Feb;44(2):190-206
pubmed: 22180307
Endosc Int Open. 2017 May;5(5):E363-E375
pubmed: 28497108
World J Gastroenterol. 2014 Aug 21;20(31):10758-68
pubmed: 25152579
Histopathology. 2013 Mar;62(4):602-8
pubmed: 23379782
Surg Endosc. 2017 Jan;31(1):225-230
pubmed: 27194261
Pancreas. 2018 Sep;47(8):990-995
pubmed: 30028448
Dig Liver Dis. 2015 Nov;47(11):943-9
pubmed: 26216067
Clin Gastroenterol Hepatol. 2018 Aug;16(8):1314-1321
pubmed: 28733257
Endoscopy. 2017 Oct;49(10):989-1006
pubmed: 28898917
Gastrointest Endosc. 2012 Aug;76(2):321-7
pubmed: 22658389
Endoscopy. 2015 Apr;47(4):308-14
pubmed: 25521572
Stat Med. 1998 Jan 15;17(1):101-10
pubmed: 9463853
Curr Opin Chem Biol. 2002 Aug;6(4):434-8
pubmed: 12133717
Cytojournal. 2014 Jun 02;11(Suppl 1):4
pubmed: 25191518
Diagn Cytopathol. 2017 Jan;45(1):29-35
pubmed: 27863178
Endoscopy. 2016 Jul;48(7):632-8
pubmed: 27129137
Endosc Int Open. 2016 Jul;4(7):E812-9
pubmed: 27556103
Endosc Ultrasound. 2017 Sep-Oct;6(5):300-307
pubmed: 29063873
Gastrointest Endosc. 2019 Feb;89(2):329-339
pubmed: 30367877
Clin Gastroenterol Hepatol. 2018 Aug;16(8):1307-1313.e1
pubmed: 28624647
Endoscopy. 2016 Apr;48(4):339-49
pubmed: 26561917
United European Gastroenterol J. 2015 Aug;3(4):343-52
pubmed: 26279842
Endosc Ultrasound. 2016 Jan-Feb;5(1):1-3
pubmed: 26879159
N Engl J Med. 2015 Jun 4;372(23):2229-34
pubmed: 26014593
Scand J Gastroenterol. 2014 Mar;49(3):347-54
pubmed: 24325591
Gastrointest Endosc. 2013 Jun;77(6):909-15
pubmed: 23433596
Gastrointest Endosc Clin N Am. 2014 Jan;24(1):19-27
pubmed: 24215758
Clin Gastroenterol Hepatol. 2018 Jul;16(7):1114-1122.e2
pubmed: 28911946
Pancreas. 2015 Jan;44(1):128-33
pubmed: 25232713
Korean J Intern Med. 2016 Nov;31(6):1073-1083
pubmed: 27586867
Cytojournal. 2014 Jun 02;11(Suppl 1):3
pubmed: 25191517