EUS-guided tissue acquisition in the study of the adrenal glands: Results of a nationwide multicenter study
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...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2019 |
| País: | España |
| Institución: | Universitat Oberta de Catalunya (UOC) |
| Repositorio: | O2, repositorio institucional de la UOC |
| OAI Identifier: | oai:openaccess.uoc.edu:10609/101699 |
| Acceso en línea: | https://hdl.handle.net/10609/101699 |
| Access Level: | acceso abierto |
| Palabra clave: | Endoscopic ultrasonography Diagnosis Ecografía endoscópica Diagnóstico Drainage Surgical Endoscopis Drenaje quirúrgico |
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EUS-guided tissue acquisition in the study of the adrenal glands: Results of a nationwide multicenter studyMartín Cardona, AlbertFernández Esparrach, GloriaSúbtil Íñigo, José CarlosIglesias García, JulioGarcía Guix, MartaBarturen Barroso, AngelGimeno García, Antonio Z.Esteban, José MiguelPardo Balteiro, AlbertVelasco Guardado, AntonioVazquez Sequeiros, EnriqueLORAS ALASTRUEY, CARMEMartínez Moreno, BelénCastellot Martín, AnaHuertas Nadal, CarlosMartínez Lapiedra, MamenSánchez Yague, AndrésTeran, ÁlvaroMorales Alvarado, Víctor J.Betés Ibáñez, Maria TeresaIglesia, Daniel de laSánchez Montes, CristinaLozano Escario, María DoloresLariño Noia, JoséGinès, ÀngelsTebe, Cristiangornals, joan bEndoscopic ultrasonographyDiagnosisEcografía endoscópicaDiagnósticoEndoscopic ultrasonographyDrainageSurgicalEndoscopisEcografía endoscópicaDrenaje quirúrgicoBackground: 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.PLoS ONEUniversitat Oberta de Catalunya (UOC)201920192019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/10609/101699reponame:O2, repositorio institucional de la UOCinstname:Universitat Oberta de Catalunya (UOC)Ingléshttps://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0216658&type=printablecc-byhttp://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:openaccess.uoc.edu:10609/1016992026-05-28T12:42:01Z |
| dc.title.none.fl_str_mv |
EUS-guided tissue acquisition in the study of the adrenal glands: Results of a nationwide multicenter study |
| title |
EUS-guided tissue acquisition in the study of the adrenal glands: Results of a nationwide multicenter study |
| spellingShingle |
EUS-guided tissue acquisition in the study of the adrenal glands: Results of a nationwide multicenter study Martín Cardona, Albert Endoscopic ultrasonography Diagnosis Ecografía endoscópica Diagnóstico Endoscopic ultrasonography Drainage Surgical Endoscopis Ecografía endoscópica Drenaje quirúrgico |
| title_short |
EUS-guided tissue acquisition in the study of the adrenal glands: Results of a nationwide multicenter study |
| title_full |
EUS-guided tissue acquisition in the study of the adrenal glands: Results of a nationwide multicenter study |
| title_fullStr |
EUS-guided tissue acquisition in the study of the adrenal glands: Results of a nationwide multicenter study |
| title_full_unstemmed |
EUS-guided tissue acquisition in the study of the adrenal glands: Results of a nationwide multicenter study |
| title_sort |
EUS-guided tissue acquisition in the study of the adrenal glands: Results of a nationwide multicenter study |
| dc.creator.none.fl_str_mv |
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 Iglesia, Daniel de la Sánchez Montes, Cristina Lozano Escario, María Dolores Lariño Noia, José Ginès, Àngels Tebe, Cristian gornals, joan b |
| author |
Martín Cardona, Albert |
| author_facet |
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 Iglesia, Daniel de la Sánchez Montes, Cristina Lozano Escario, María Dolores Lariño Noia, José Ginès, Àngels Tebe, Cristian gornals, joan b |
| author_role |
author |
| author2 |
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 Iglesia, Daniel de la Sánchez Montes, Cristina Lozano Escario, María Dolores Lariño Noia, José Ginès, Àngels Tebe, Cristian gornals, joan b |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Universitat Oberta de Catalunya (UOC) |
| dc.subject.none.fl_str_mv |
Endoscopic ultrasonography Diagnosis Ecografía endoscópica Diagnóstico Endoscopic ultrasonography Drainage Surgical Endoscopis Ecografía endoscópica Drenaje quirúrgico |
| topic |
Endoscopic ultrasonography Diagnosis Ecografía endoscópica Diagnóstico Endoscopic ultrasonography Drainage Surgical Endoscopis Ecografía endoscópica Drenaje quirúrgico |
| description |
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. |
| publishDate |
2019 |
| dc.date.none.fl_str_mv |
2019 2019 2019 |
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info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
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article |
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publishedVersion |
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https://hdl.handle.net/10609/101699 |
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https://hdl.handle.net/10609/101699 |
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Inglés |
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Inglés |
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https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0216658&type=printable |
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cc-by http://creativecommons.org/licenses/by/3.0/es/ info:eu-repo/semantics/openAccess |
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cc-by http://creativecommons.org/licenses/by/3.0/es/ |
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openAccess |
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application/pdf |
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PLoS ONE |
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PLoS ONE |
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reponame:O2, repositorio institucional de la UOC instname:Universitat Oberta de Catalunya (UOC) |
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