title: A prospective, comparative trial to optimize sampling techniques in EUS-guided FNA of solid pancreatic masses.
abstract: BACKGROUND
  There is no standardization of the use of suction during puncturing of a target in pancreatic EUS-guided FNA (EUS-FNA). It is also debatable whether expressing aspirates from the needle by the traditional method of reinserting the stylet is more effective than by air flushing, which is easier and safer.
  
  
  OBJECTIVE
  To optimize sampling techniques in pancreatic EUS-FNA.
  
  
  METHODS
  Prospective, comparative trial.
  
  
  METHODS
  Tertiary-care referral center.
  
  
  METHODS
  Eighty-one consecutive patients with solid pancreatic masses.
  
  
  METHODS
  Four punctures were performed for each mass in random order by a 2 × 2 factorial design. Sample quality and diagnostic yield were compared between samples with suction (S+) versus no suction (S-) and expressed by reinserting the stylet (RS) versus air flushing (AF).
  
  
  METHODS
  Sample quality by the number of diagnostic samples, cellularity, bloodiness, and air-drying artifact; diagnostic yield by accuracy, sensitivity, and specificity.
  
  
  RESULTS
  The number of diagnostic samples (72.8% vs 58.6%; P = .001), cellularity (odds ratio [OR] 2.12; 95% confidence interval [CI], 1.37-3.30; P < .001), bloodiness (OR 1.46; CI, 1.28-1.68; P < .001), accuracy (85.2% vs 75.9%; P = .004), and sensitivity (82.4% vs 72.1%; P = .005) were higher in S+ than in S-. Bloodiness was lower in AF than in RS (OR 1.16; CI, 1.03-1.30; P = .017).
  
  
  CONCLUSIONS
  Single-center trial, 2 kinds of needle gauges, and no immediate cytopathology evaluation.
  
  
  CONCLUSIONS
  Puncturing with suction and expressing by air flushing may be used preferentially in pancreatic EUS-FNA because they were more effective and convenient techniques. (
  
  
  BACKGROUND
  NCT01354795.).
authors: Department of Internal Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Seoul, Republic of Korea.
authors: Jun Kyu
authors: JK
authors: Lee
authors: Jong Hak
authors: JH
authors: Choi
authors: Kwang Hyuck
authors: KH
authors: Lee
authors: Kwang Min
authors: KM
authors: Kim
authors: Jae Uk
authors: JU
authors: Shin
authors: Jong Kyun
authors: JK
authors: Lee
authors: Kyu Taek
authors: KT
authors: Lee
authors: Kee-Taek
authors: KT
authors: Jang
mesh_terms: D000388:Air; D016001:Confidence Intervals; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010190:Pancreatic Neoplasms / Q000473:pathology*; D012680:Sensitivity and Specificity; D013396:Suction