ABSTRACT
Objective:To investigate the features of endoscopic ultrasonography in the diagnosis of malignant mediastinal and abdominal lymphadenopathy and to provide more evidence for endoscopic ultrasound-guided fine-needle aspiraiton (EUS-FNA).Methods:A case-control study was performed on 83 consecutive patients who underwent EUS in the Second Affiliated Hospital of Soochow University from September 2016 to February 2021. Lymph node properties were identified by pathological results of EUS-FNA and (or) surgery and follow-up for at least 6 months. According to the final diagnosis, patients were divided into malignant lymph node group ( n=56) and benign lymph node group ( n=27). Univariate analysis and multivariate logistic analysis were performed to identify independent risk factors for malignant lymphadenopathy in terms of EUS features. Results:Univariate analysis showed that the length of short axis, short-long axis ratio, shape, border, presence or absence of hilum, heterogeneous echo, and the growth pattern of lymph node were risk factors for malignant lymph nodes ( P<0.10). Multivariate logistic regression analysis showed that short axis>10 mm ( P=0.021, OR=9.751, 95% CI: 1.407-57.573), clear border ( P=0.009, OR=20.587, 95% CI: 2.149-197.251), absence of hilum ( P=0.019, OR=28.502, 95% CI: 1.725-470.864), nodal matting ( P=0.004, OR=45.539, 95% CI: 3.429-604.822), partial nodal fusion ( P=0.004, OR=50.012, 95% CI: 3.497-715.266) were independent risk factors for malignant mediastinal and abdominal lymph nodes. Conclusion:EUS is useful to differentiate the lymph node properties in the mediastinal or abdominal cavity. Short axis>10 mm, clear border, absence of hilum, nodal matting and partial nodal fusion are high-risk EUS features of malignant mediastinal or abdominal lymphadenopathy, where priority should be given to EUS-FNA.
ABSTRACT
Objective@#To study the feasibility of establishing human 3D pancreatic cancer organoids with endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) specimen.@*Methods@#A total of 9 patients with suspected pancreatic masses were prospectively included in this study from June 2017 to January 2018. EUS-FNA was performed for initial diagnosis. The biopsy tissues were obtained from a COOK 22-gauge FNA needle for organoid establishment, and the growth status in vitro was observed.@*Results@#Nine specimens of pancreatic lesions obtained from EUS-FNA were enrolled. Successful establishment of organoids was achieved in 5 cases, which were all confirmed to be pancreatic cancer histopathologically. In the process of generating, the growth rate of organoids increased correspondingly. The pathological morphology of these organoids was similar to the corresponding pancreatic tissues in HE staining.@*Conclusion@#Pancreatic cancer organoids can be successfully created by means of EUS-FNA. Establishment of these organoids can potentially provide excellent models for patients with pancreatic cancer in guiding precision treatment.
ABSTRACT
Objective To study the feasibility of establishing human 3D pancreatic cancer organoids with endoscopic ultrasound-guided fine-needle aspiration ( EUS-FNA ) specimen. Methods A total of 9 patients with suspected pancreatic masses were prospectively included in this study from June 2017 to January 2018. EUS-FNA was performed for initial diagnosis. The biopsy tissues were obtained from a COOK 22-gauge FNA needle for organoid establishment, and the growth status in vitro was observed. Results Nine specimens of pancreatic lesions obtained from EUS-FNA were enrolled. Successful establishment of organoids was achieved in 5 cases, which were all confirmed to be pancreatic cancer histopathologically. In the process of generating, the growth rate of organoids increased correspondingly. The pathological morphology of these organoids was similar to the corresponding pancreatic tissues in HE staining. Conclusion Pancreatic cancer organoids can be successfully created by means of EUS-FNA. Establishment of these organoids can potentially provide excellent models for patients with pancreatic cancer in guiding precision treatment.
ABSTRACT
Objective To evaluate the factors influencing the diagnostic positivity of endoscopic ultrasonography guided fine needle aspiration (EUS-FNA) for small size pancreatic carcinoma (SSPC) and the occurrence of the adverse events after the aspiration.Methods 51 patients with SSPC ≤2 cm in diameter treated in Changhai hospital from February 2008 to January 2015 were retrospectively studied.The gender,age,tumor diameter,location,the dilation of pancreatic ducts,the number of aspirations and the needle passages,the usage of negative pressure during aspiration,the pathological examination of the specimens and postoperative adverse events and the like were collected.Univariate analysis and logistic regression analyze were applied to determine the factors influencing the diagnostic positivity of EUS-FNA for SSPC and postoperative adverse events.Results Among the 51 patients,positive cytology outcome were identified in 30 patients,which were negative in 21 patients.Univariate analysis identified that there were no statistical differences on the age,sex,dilated pancreatic duct,the number of aspirations and needle passages between two groups (P value ＞0.05).The diagnostic positivity using the 10ml minor negative pressure was obviously higher than that using 20 ml negative pressure,and the differences were statistically significant (P =0.028).Multivariate logistic regression identified 10ml minor negative pressure was easier to obtain positive cytology outcome (Odds Ratio 0.2810,95％ CI 0.093-0.851).In addition,the number of passages in patients with postoperative adverse events was greater than those without postoperative adverse events (30 vs 20),and the difference was statistically significant (P =0.034).Conclusions The introduction of 10 ml negative pressure could improve the diagnostic positivity of EUS-FNA for SSPC,and the increased number of needle passages may increase the occurrence rate of postoperative adverse events.
ABSTRACT
Objective To evaluate the diagnostic value of endoscopic ultrasonography (EUS) guided fine needle aspiration (FNA) in patients with suspected chronic pancreatitis. Methods Forty seven patients including 28 males and 19 females (mean age 52.3 years, range 47～69 years) were enrolled into study. The diagnosis of chronic pancreatitis or pancreatic malignancy was based on results of BT PABA test, Sudan Ⅲ staining of stool and abdominal CT scanning, the mean course of disease was 6.3 year (range 3 21 year). Pancreatic tissue specimens were harvested by EUS guided FNA and investigated by histopathological study. Results Totally 31 cases (31/47, 69%) were diagnosed as chronic pancreatitis based on histopathological examination of the specimens taken by EUS FNA. Conclusion EUS FNA had the potential clinical value in diagnosis of chronic pancreatitis.