Copyright
©The Author(s) 2021.
World J Clin Cases. Dec 6, 2021; 9(34): 10507-10517
Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10507
Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10507
Table 1 Baseline patient characteristics, lesion details, and sampling characteristics
| Results | Total | FNA | FNB | P value |
| Patient characteristics | ||||
| No. of patients | 1168 | 468 (40.07) | 700 (59.93) | |
| Age (yr) | 65.02 (12.29) | 64.24 (11.59) | 65.54 (12.72) | 0.078 |
| Gender | 0.098 | |||
| No. of males (%) | 652 (55.82) | 275 (58.76) | 377 (52.86) | |
| No. of females (%) | 516 (44.18) | 193 (41.24) | 323 (47.14) | |
| Lesion site | ||||
| Pancreatic | 574 (49.14) | 194 (41.45) | 380 (54.29) | < 0.001 |
| Non-pancreatic | ||||
| Lymph node | 209 (17.89) | 108 (23.08) | 101 (14.43) | < 0.001 |
| Subepithelial | 229 (19.61) | 115 (24.57) | 114 (16.28) | < 0.001 |
| Other solid lesions | 156 (13.36) | 51 (10.90) | 105 (15.00) | < 0.001 |
| Hepatic mass | 48 (4.11) | 18 (37.50) | 30 (62.50) | |
| Abdominal mass | 29 (2.48) | 8 (27.59) | 21 (72.41) | |
| Gastrointestinal wall thickening | 20 (1.71) | 6 (0.30) | 14 (0.70) | |
| Mediastinal mass | 14 (0.43) | 4 (28.57) | 10 (71.43) | |
| Peri-rectal mass | 11 (0.94) | 3 (27.37) | 8 (72.73) | |
| Common bile duct mass | 9 (0.77) | 5 (55.56) | 4 (44.44) | |
| Duodenal mass | 6 (0.51) | 1 (16.67) | 5 (83.33) | |
| Ampullary mass | 6 (0.51) | 1 (16.67) | 5 (83.33) | |
| Retroperitoneal mass | 5 (0.43) | 1 (20.00) | 4 (80.00) | |
| Esophageal mass | 3 (0.26) | 0 (0.00) | 3 (100.00) | |
| Gallbladder mass | 3 (0.26) | 2 (66.67) | 1 (33.33) | |
| Splenic mass | 2 (0.17) | 2 (100.00) | 0 (0.00) | |
| Lesion size (mm) | 24.16 (13.63) | 22.10 (13.34) | 25.52 (13.65) | < 0.001 |
| Diagnostic sample approach | 0.007 | |||
| Transesophageal | 124 (11.02) | 63 (50.81) | 61 (49.19) | |
| Transgastric | 589 (52.36) | 235 (39.90) | 354 (60.10) | |
| Tranduodenal | 388 (34.49) | 135 (34.79) | 253 (65.21) | |
| Transrectal | 21 (1.87) | 11 (52.38) | 10 (47.62) | |
| Other | 3 (0.26) | 0 (0.00) | 3 (100.00) | |
| Needle size | < 0.001 | |||
| 19G | 8 (0.69) | 2 (0.43) | 6 (0.86) | |
| 20G | 7 (0.61) | 0 (0.00) | 7 (1.00) | |
| 21G | 8 (0.69) | 0 (0.00) | 8 (1.15) | |
| 22G | 644 (55.61) | 216 (46.55) | 428 (61.49) | |
| 25G | 491 (42.40) | 246 (53.02) | 245 (35.20) | |
| No. of passes | 2.89 (1.51) | 2.91 (1.61) | 2.88 (1.45) | 0.701 |
| No. of samples with ROSE | < 0.001 | |||
| Yes | 377 (32.28) | 182 (38.89) | 195 (27.86) | |
| No | 791 (67.72) | 286 (61.11) | 505 (72.14) | |
| Adequate sample for ROSE | 0.474 | |||
| Yes | 291 (77.19) | 136 (74.73) | 155 (79.49) | |
| No | 86 (22.81) | 46 (25.27) | 40 (20.51) | |
| No. of passes for ROSE adequacy | 3.37 (1.73) | 3.32 (1.74) | 3.41 (1.73) | 0.664 |
| No. of samples with cell block | < 0.001 | |||
| Yes | 1014 (86.82) | 366 (78.21) | 648 (92.57) | |
| No | 154 (13.18) | 102 (21.79) | 52 (7.43) | |
| No. of passes for cell block diagnosis | 2.97 (1.54) | 3.09 (1.67) | 2.90 (1.46) | 0.067 |
Table 2 Summary of diagnostic results
| Total | FNA | FNB | P value | |
| All Lesions | ||||
| Sensitivity | 81.02% (95%CI 78.27 to 83.56) | 74.53% (95%CI 69.37 to 79.23) | 84.70% (95%CI 81.45 to 87.57) | < 0.001 |
| Specificity | 97.92% (95%CI 95.54 to 99.23) | 96.62% (95%CI 92.29 to 98.89) | 99.29% (95%CI 96.11 to 99.98) | < 0.001 |
| Positive likelihood ratio | 39.03 (95%CI 17.67 to 86.20) | 22.06 (95%CI 9.30 to 52.34) | 119.42 (95%CI 16.93 to 842.21) | < 0.001 |
| Negative likelihood ratio | 0.19 (95%CI 0.17 to 0.22) | 0.26 (95%CI 0.22 to 0.32) | 0.15 (95%CI 0.13 to 0.19) | 0.676 |
| Positive predictive value | 99.17% (95%CI 98.18 to 99.62) | 97.93% (95%CI 95.23 to 99.12) | 99.79% (95%CI 98.54 to 99.97) | < 0.001 |
| Negative predictive value | 62.89% (95%CI 59.63 to 66.04) | 63.84% (95%CI 59.34 to 68.11) | 61.95% (95%CI 57.26 to 66.43) | 0.459 |
| Accuracy | 85.20% (95%CI 83.03 to 87.19) | 81.55% (95%CI 77.72 to 84.96) | 87.62% (95%CI 84.96 to 89.97) | 0.004 |
| Serious adverse events | 2 (0.17) | 1 (0.21) | 1 (0.14) | 0.775 |
| Pancreatic lesions | ||||
| Sensitivity | 87.96% (95%CI 84.74 to 90.71) | 85.62% (95%CI 79.22 to 90.66) | 89.09% (95%CI 85.22 to 92.24) | 0.229 |
| Specificity | 97.59% (95%CI 91.57 to 99.71) | 96.88% (95%CI 83.78 to 99.92) | 98.04% (95%CI 89.55 to 99.95) | 0.387 |
| Positive likelihood ratio | 36.50 (95%CI 9.28 to 143.58) | 27.40 (95%CI 3.98 to 188.81) | 45.44 (95%CI 6.52 to 316.51) | 0.714 |
| Negative likelihood ratio | 0.12 (95%CI 0.10 to 0.16) | 0.15 (95%CI 0.10 to 0.22) | 0.11 (95%CI 0.08 to 0.15) | 0.253 |
| Positive predictive value | 99.54% (95%CI 98.21 to 99.88) | 99.28% (95%CI 95.21 to 99.89) | 99.66% (95%CI 97.69 to 99.95) | 0.529 |
| Negative predictive value | 57.86% (95%CI 51.88 to 63.61) | 57.41% (95%CI 47.88 to 66.41) | 58.14% (95%CI 50.44 to 65.46) | 0.867 |
| Accuracy | 89.35% (95%CI 86.54 to 91.76) | 87.50% (95%CI 81.97 to 91.82) | 90.29% (95%CI 86.86 to 93.07) | 0.307 |
| Serious adverse events | 1 (0.17) | 0 (0.00) | 1 (0.26) | 0.821 |
| Non-pancreatic lesions | ||||
| Sensitivity | 72.31% (95%CI 67.58 to 76.69) | 63.29% (95%CI 55.27 to 70.81) | 78.45% (95%CI 72.59 to 83.56) | < 0.001 |
| Specificity | 98.07% (95%CI 95.13 to 99.47) | 96.52% (95%CI 91.33 to 99.04) | 100.00% (95%CI 96.07 to 100.00) | < 0.001 |
| Positive likelihood ratio | 37.42 (95%CI 14.15 to 98.95) | 18.20 (95%CI 6.90 to 48.01) | NA | NA |
| Negative likelihood ratio | 0.28 (95%CI 0.24 to 0.33) | 0.38 (95%CI 0.31 to 0.47) | 0.22 (95%CI 0.17 to 0.28) | 0.719 |
| Positive predictive value | 98.60% (95%CI 96.38 to 99.47) | 96.15% (95%CI 90.45 to 98.51) | 100.00% | < 0.001 |
| Negative predictive value | 65.27% (95%CI 61.53 to 68.84) | 65.68% (95%CI 60.86 to 70.20) | 64.79% (95%CI 59.01 to 70.17) | 0.820 |
| Accuracy | 81.24% (95%CI 77.87 to 84.29) | 77.29% (95%CI 71.85 to 82.12) | 84.57% (95%CI 80.17 to 88.32) | 0.023 |
| Serious adverse events | 1 (0.16) | 1 (0.87) | 0 (0.00) | 0.321 |
Table 3 Comparison between methods with and without rapid on-site evaluation
| FNA alone | FNA with ROSE | FNB alone | FNB with ROSE | |
| Sensitivity | 63.19% (95%CI 55.29 to 70.60) | 86.45% (95%CI 80.04 to 91.41) | 81.66% (95%CI 77.50 to 85.34) | 82.97% (95%CI 76.70 to 88.12) |
| Specificity | 96.69% (95%CI 91.75 to 99.06) | 100.00% (95%CI 86.77 to 100.00) | 100.00% (95%CI 95.04 to 100.00) | 100.00% (95%CI 75.29 to 100.00) |
| Positive likelihood ratio | 19.12 (95%CI 7.24 to 50.46) | NA | 89.82 (95%CI 12.76 to 632.37) | NA |
| Negative likelihood ratio | 0.38 (95%CI 0.31 to 0.47) | 0.14 (95%CI 0.09 to 0.20) | 0.19 (95%CI 0.15 to 0.23) | 0.17 (95%CI 0.12 to 0.23) |
| Positive predictive value | 96.26% (95%CI 90.70 to 98.55) | 100.00% | 99.69% (95%CI 97.88 to 99.96) | 100.00% |
| Negative predictive value | 66.10% (95%CI 61.40 to 70.51) | 55.32% (95%CI 45.41 to 64.82) | 59.89% (95%CI 54.81 to 64.77) | 29.55% (95%CI 23.33 to 36.62) |
| Accuracy | 77.46% (95%CI 72.16 to 82.19) | 88.40% (95%CI 82.81 to 92.67) | 85.43% (95%CI, 82.06 to 88.39) | 84.10% (95%CI 78.20 to 88.94) |
Table 4 Statistical analyses between methods with and without rapid on-site evaluation
| FNA vs FNA + ROSE (P value) | FNA vs FNB (P value) | FNA vs FNB + ROSE (P value) | FNA + ROSE vs FNB (P value) | FNA + ROSE vs FNB + ROSE (P value) | FNB vs FNB + ROSE (P value) | |
| Sensitivity | < 0.001 | < 0.001 | < 0.001 | 0.142 | 0.350 | 0.686 |
| Specificity | 0.014 | 0.014 | 0.010 | 1.000 | 1.000 | 0.182 |
| Positive likelihood ratio | NA | < 0.001 | NA | NA | NA | NA |
| Negative likelihood ratio | 0.637 | 0.614 | 0.677 | 0.891 | 0.941 | 0.956 |
| Accuracy | 0.003 | 0.005 | 0.074 | 0.320 | 0.228 | 0.658 |
- Citation: Moura DTH, McCarty TR, Jirapinyo P, Ribeiro IB, Farias GFA, Madruga-Neto AC, Ryou M, Thompson CC. Endoscopic ultrasound fine needle aspiration vs fine needle biopsy in solid lesions: A multi-center analysis. World J Clin Cases 2021; 9(34): 10507-10517
- URL: https://www.wjgnet.com/2307-8960/full/v9/i34/10507.htm
- DOI: https://dx.doi.org/10.12998/wjcc.v9.i34.10507