EUS-guided tissue acquisition in the study of the adrenal glands: Results of a nationwide multicenter study
Martin-Cardona, A.; Fernandez-Esparrach, G.; Subtil, J. C.; IGLESIAS GARCIA, JULIO; Garcia-Guix, M.; Barturen Barroso, A.; Gimeno-Garcia, A. Z.; Esteban, J. M.; Pardo Balteiro, A.; Velasco-Guardado, A.; Vazquez-Sequeiros, E.; Loras, C.; Martinez-Moreno, B.; Castellot, A.; Huertas, C.; Martinez-Lapiedra, M.; Sanchez-Yague, A.; Teran, A.; Morales-Alvarado, V. J.; Betes, M.; DE LA IGLESIA GARCIA, DANIEL; Sánchez-Montes, C.; Lozano, M. D.; Lariño Noia, José; Gines, A.; Tebe, C.; Gornals, J. B.
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Identificadores
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Autor corporativo
Spanish Group for EUS-Guided TA in the adrenal glandFecha de publicación
2019Título de revista
PLoS One
Tipo de contenido
Artigo
Resumen
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 lung70%, others19%, and unknown11%. 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.
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