Rapid on-site cytopathological examination (ROSE) performed by endosonagraphers and its improvement in the diagnosis of pancreatic solid lesions.
OBJECTIVE
To evaluate the diagnosis improvement of EUS-FNA when using ROSE performed by the endosonographer.


METHODS
A retrospective study was conducted. A total of 48 pancreatic solid masses EUS-FNA were divided into two groups according to the availability of on-site cytology (ROSE) - the first 24 patients (group A-without ROSE) and the latter 24 cases (group B-with ROSE). Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, complications and inadequacy rate of EUS-FNA were determined and compared.


RESULTS
Among the 48 EUS-FNA, the overall performance was: sensitivity 82%; specificity 100%; positive predictive value (PPV) 100%; negative predictive value (NPV) 70% and accuracy 87%. The sensitivity of the Group A was 71%, versus 94% in-group B (p=0.61). Moreover, the negative predictive value was 58% versus 87% (p=0.72). The accuracy rate increased from 79% to 96% (p=0.67) in the ROSE group. The number of punctures was similar between the groups. No major complications were reported.


CONCLUSIONS
Rapid on-site cytopathological examination, even when performed by the endosonographer, may improve the diagnostic performance in the diagnosis of solid pancreatic lesions, regardless of the slight increase in the number of punctures.
Faculdade de Ciências Médicas, Santa Casa de São Paulo, Sao Paulo, SP, Brazil.
Ricardo Leite
RL
Ganc
Faculdade de Ciências Médicas, Santa Casa de São Paulo, Sao Paulo, SP, Brazil.
Augusto Pincke Cruz
AP
Carbonari
Faculdade de Ciências Médicas, Santa Casa de São Paulo, Sao Paulo, SP, Brazil.
Rogério
R
Colaiacovo
French Brazilian Centre of Endoscopic Ultrasound, Sao Paulo, SP, Brazil.
Júlia
J
Araujo
French Brazilian Centre of Endoscopic Ultrasound, Sao Paulo, SP, Brazil.
Sheila
S
Filippi
Endoscopy Department, Sirio-Libanes Hospital, Sao Paulo, SP, Brazil.
Rodrigo Altenfender
RA
Silva
Endoscopy Department, Sirio-Libanes Hospital, Sao Paulo, SP, Brazil.
Adhemar Monteiro
AM
Pacheco Junior
FCMSCSP, Sao Paulo, SP, Brazil.
Lucio Giovanni Battista
LG
Rossini
Institut Paoli-Calmettes, Marseille, France.
Marc
M
Giovannini
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods / Q000592:standards*; D019160:Endosonography / Q000379:methods / Q000592:standards*; D006801:Humans; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology*; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D011446:Prospective Studies; D058996:Quality Improvement; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity