The Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine Needle Aspiration in Patients with Endoscopic Biopsy Negative Upper Gastrointestinal Lesions | [Annals of the Pakistan Institute of Medical Sciences • 2021]

Author(s):

1. Muhammad Najm ul Hasan Shafi: Postgraduate resident, Pak Emirates Military Hospital, Rawalpindi, Pakistan

2. Muhammad Ismail: Postgraduate resident, Pak Emirates Military Hospital, Rawalpindi,Pakistan

3. Irfan Ali: Postgraduate resident, Pak Emirates Military Hospital, Rawalpindi, Pakistan

4. Hassam Zulfiqar: Postgraduate resident, Rawalpindi Medical University, Rawalpindi, Pakistan

5. Izatullah: Rawalpindi Medical University, Rawalpindi, Pakistan

6. Rao Saad Ali Khan: Pak Emirates Military Hospital, Rawalpindi, Pakistan

Abstract:

Objective: To determine the diagnostic accuracy of endoscopic ultrasound guided (EUS) fine needle aspiration in patients who had inconclusive endoscopic biopsies of the same lesion. Methodology: This retrospective study was conducted at Pak Emirates Military Hospital, Rawalpindi, Pakistan from January 2018 to July 2020. Patients who underwent EUS guided FNAC were screened. The FNAC results of patients satisfying the inclusion criteria were compared with either a surgical biopsy in patients in whom surgeries were done, while in the remaining patients, EUS FNAC results were compared with a 3 months radiological and/or 6 months clinical follow-up. Results: The final diagnosis was defined based on the following criteria: (1) Malignant lesions (n=36), histopathologic diagnosis obtained based on surgery resected samples (n=18) or clinical diagnosis as neoplasm based on clinical follow-up of symptoms (n=30) or radiologic diagnosis based on imaging follow-up at 3 months (n=13) (2) Benign lesions (n=18), benign cytopathologic histopathologic findings and clinical follow-up with no evidence of malignant progression or metastasis. EUS-guided FNA cytology turned out to be malignant in 60 percent (n=36) of the specimens. 30 percent of the samples showed benign epithelial cytology (n=18) while in 10 percent of the cases (n=6), the tissue samples were deemed insufficient for cytological diagnosis. The accuracy came out to be 66.6 percent (n=10 were true negative), sensitivity 93.4 percent, and specificity 100 percent. Conclusion: EUS guided-FNA cytology of the sub-mucosal upper GI lesions is highly sensitive and specific for upper GI lesions, which are negative on endoscopic biopsies.

Page(s): 190-195

DOI: DOI not available

Published: Journal: Annals of the Pakistan Institute of Medical Sciences, Volume: 17, Issue: 2, Year: 2021

Keywords:

Diagnostic accuracy , Endoscopic ultrasound EUS , Fine needle aspiration cytology FNAC

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