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Diagnostic yield of malignancy during EUS-guided FNA of solid lesions with and without a stylet

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dc.contributor.author Azar, Riad R.
dc.contributor.author Wani, Sachin
dc.contributor.author Early, Dayna
dc.contributor.author Kunkel, Julie
dc.contributor.author Leathersich, Ann
dc.contributor.author Hovis, Christine E.
dc.contributor.author Hollander, Thomas G.
dc.contributor.author Kohlmeier, Cara
dc.contributor.author Zelenka, Cynthia
dc.date.accessioned 2016-09-27T05:55:11Z
dc.date.available 2016-09-27T05:55:11Z
dc.date.copyright 2012 en_US
dc.identifier.issn 0016-5107 en_US
dc.identifier.uri http://hdl.handle.net/10725/4409
dc.description.abstract Background Use of a stylet during EUS-guided FNA (EUS-FNA) is believed to improve the quality and diagnostic yield of specimens. Objective To compare samples obtained by EUS-FNA with (S+) and without (S−) a stylet for diagnostic yield of malignancy and cytological characteristics. Design Randomized, controlled trial. Setting Tertiary referral center. Patients Consecutive patients referred for EUS-FNA of solid lesions. Intervention EUS-FNA; the number of passes was determined by lesion site (6 pancreas/others and 4 lymph nodes). Main Outcome Measurements Diagnostic yield of malignancy and degree of cellularity, specimen adequacy, contamination, and amount of blood. Results One hundred patients were prospectively enrolled in this randomized, controlled trial and the sites of EUS-FNA were the pancreas, 58; lymph node, 25; and other, 17. The overall diagnosis was malignancy in 56, benign in 30, suspicious/atypical in 7, and inadequate specimen in 7 lesions. There were 550 passes made (275 with a stylet and 275 without a stylet). Interim analysis demonstrated no difference in the diagnostic yield of malignancy (94 passes with a stylet [34.2%] vs 110 without a stylet [40%], P = .2) and in the proportion of inadequate specimens (57 with a stylet [20.7%] vs 64 without a stylet [23.3%], P = .2). There was no difference with regard to cellularity (P = .83), contamination (P = .31), number of cells (P = .25), and amount of blood (P = .6). Similar results were noted in a subgroup analysis based on lesion site. Applying the rules of futility, the study was terminated. Limitations Subjectivity in cytopathologists' assessment, endosonographer not blinded. Conclusions There was no difference in the diagnostic yield of malignancy or proportion of inadequate specimens between passes with and without a stylet. These results suggest that the use of a stylet does not confer any advantage during EUS-FNA. (Clinical trial registration number: NCT01316614.) en_US
dc.language.iso en en_US
dc.title Diagnostic yield of malignancy during EUS-guided FNA of solid lesions with and without a stylet en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle a prospective, single blind, randomized, controlled trial en_US
dc.author.school SOM en_US
dc.author.idnumber 200902767 en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Gastrointestinal Endoscopy en_US
dc.journal.volume 76 en_US
dc.journal.issue 2 en_US
dc.article.pages 328-335 en_US
dc.identifier.doi http://dx.doi.org/10.1016/j.gie.2012.03.1395 en_US
dc.identifier.ctation Wani, S., Early, D., Kunkel, J., Leathersich, A., Hovis, C. E., Hollander, T. G., ... & Collins, B. (2012). Diagnostic yield of malignancy during EUS-guided FNA of solid lesions with and without a stylet: a prospective, single blind, randomized, controlled trial. Gastrointestinal endoscopy, 76(2), 328-335. en_US
dc.author.email riad.azar@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url http://www.sciencedirect.com/science/article/pii/S0016510712016823 en_US


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