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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(11): E1379-E1385
DOI: 10.1055/a-2422-9363
Original article

Evaluating endoscopic ultrasound-guided tissue acquisition for diagnosis of small pancreatic neuroendocrine neoplasms

Hiromune Katsuda
1   Gastroenterology and Hepatology, Tokyo Medical and Dental University, Bunkyo-ku, Japan (Ringgold ID: RIN13100)
,
Masanori Kobayashi 
1   Gastroenterology and Hepatology, Tokyo Medical and Dental University, Bunkyo-ku, Japan (Ringgold ID: RIN13100)
,
Go Ito
1   Gastroenterology and Hepatology, Tokyo Medical and Dental University, Bunkyo-ku, Japan (Ringgold ID: RIN13100)
,
Ami Kawamoto
1   Gastroenterology and Hepatology, Tokyo Medical and Dental University, Bunkyo-ku, Japan (Ringgold ID: RIN13100)
,
Susumu Krimura
2   Pathology, Tokyo Medical and Dental University, Bunkyo-ku, Japan (Ringgold ID: RIN13100)
,
Hiroyuki Sato
3   Clinical Biostatistics, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Bunkyo-ku, Japan (Ringgold ID: RIN92190)
,
Akihiro Hirakawa
3   Clinical Biostatistics, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Bunkyo-ku, Japan (Ringgold ID: RIN92190)
,
Keiichi Akahoshi
4   Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Japan (Ringgold ID: RIN13100)
,
Atsushi Kudo
4   Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Bunkyo-ku, Japan (Ringgold ID: RIN13100)
,
Kazuo Ohtsuka
1   Gastroenterology and Hepatology, Tokyo Medical and Dental University, Bunkyo-ku, Japan (Ringgold ID: RIN13100)
,
Ryuichi Okamoto
1   Gastroenterology and Hepatology, Tokyo Medical and Dental University, Bunkyo-ku, Japan (Ringgold ID: RIN13100)
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Abstract

Background and study aims Although small hypervascular tumors are suspected to be pancreatic neuroendocrine tumors (p-NENs), their diagnosis and treatment are challenging. This study evaluated the usefulness of endoscopic ultrasound-guided tissue acquisition (EUS-TA) for diagnosis of small p-NENs.

Methods All p-NEN lesions that underwent EUS-TA at our hospital between April 2018 and December 2023 were retrospectively analyzed. The diagnostic sensitivity of EUS-TA and the concordance rate of grading with EUS-TA and surgical specimens were examined. The lesions were grouped by size.

Results The diagnostic sensitivity of EUS-TA was analyzed for 82 lesions, of which 44 were compared with postoperative specimens for grading. The definitive diagnosis was neuroendocrine tumor (NET) in 75 lesions, neuroendocrine carcinoma in five lesions, and mixed neuroendocrine non-neuroendocrine neoplasm in two lesions. Thirty tumors were ≤10 mm, 30 were 10 to 20 mm, and 22 were >20 mm, and the diagnostic sensitivities were 96.7%, 96.7%, and 90.9%, respectively. Concordance rates for grading were 94.4%, 82.4%, and 77.8% for tumors ≤10 mm, 10 to 20 mm, and ≥20 mm, respectively, with Cohen’s kappa coefficients of 0.64, 0.48, and 0.40, respectively.

Conclusions EUS-TA showed adequate diagnostic sensitivity and grading agreement for p-NENs of all sizes, allowing for determination of appropriate treatment.

Keywords

Endoscopic ultrasonography - Pancreas - Tissue diagnosis - Fine-needle aspiration/biopsy

Supplementary Material



Publication History

Received: 11 July 2024

Accepted after revision: 26 September 2024

Accepted Manuscript online:
07 October 2024

Article published online:
28 November 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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