UEGJournal Abstracts 2021 - 767

Endoscopy and imaging
P0861
TWO NEEDLE PASSES ACHIEVE SIMILAR SENSITIVITY COMPARED TO
THREE PASSES REGARDING SOLID PANCREATIC LESION DETECTION IN
ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION
E. Koukoulioti1, G. Tziatzios1, M. Tadić2
P. Gkolfakis3
, E. Politi4
I.S Papanikolaou1
1
L.-D. Lazaridis1, K. Triantafyllou1
, S. Dimitriadis1
,
, T. Stoos-Veic2, P. Turcic2, K. Miltiadou1
, A. Vezakis5
, A. Polydorou5
,
Attikon University Hospital, National and Kapodistrian University
of Athens, Medical School, Hepatogastroenterology Unit, 2nd
Department of Internal Medicine & Research Unit, Athens, Greece,
2
KB Dubrava, University Hospital Dubrava, Zagreb, Croatia,
Institut Jules Bordet, Erasme University Hospital, Université Libre
de Bruxelles (ULB), Department of Medical Oncology, Department
of Gastroenterology, Hepatopancreatology and Digestive
Oncology, Brussels, Belgium, 4
Aretaieio Hospital, School of
3
,
P0862
ME-BLI TO JUDGE THE DEPTH OF INVASION OF EARLY ESOPHAGEAL
CANCER WITH TYPE B2 BLOOD VESSELS AND ANALYSIS OF RELATED
FACTORS
M. Zhou1
, W. Ning1, R. Shi2
1Southeast University, Nanjing, China, 2
ZhongDa Hospital
Southeast University, Gastroenterology, Nanjing, China
Aretaieion Hospital, Medical School,
National and Kapodistrian University of Athens, Department of
Cytopathology, Athens, Greece, 5
Medicine, National and Kapodistrian University of Athens, 2nd
Department of Surgery, Athens, Greece
Contact E-Mail Address: e.koukoulioti@gmail.com
Introduction: Current European Society of Gastrointestinal Endoscopy
(ESGE) guidelines advocate 3 or 4 needle passes for adequate sampling in
>90% of solid pancreatic lesions in the absence of on-site cytologic evaluation;
however, this recommendation is based on low-quality level of evidence,
due to paucity of data.
We aimed to compare two vs. three needle passes in EUS-FNA for pancreatic
lesions in terms of diagnostic yield and to identify potential factors
associated with a positive diagnosis.
Aims & Methods: Results of all needle passes in EUS-FNAs among consecutive
patients with solid pancreatic masses in two European tertiary centers
were reviewed retrospectively. All procedures were performed using
22 or 25-gauge needles under propofol sedation, without on-site cytologic
evaluation.
Primary endpoint was to assess the sensitivity of lesion detection by EUSFNA
between two groups of patients, according to number of passes (2
vs. 3), excluding cases with more or less passes. A secondary multivariate
logistic regression analysis was performed to identify patient, lesion and
procedural factors associated with diagnostic yield.
Results: 135 patients (83 male, 61.5%) with solid pancreatic masses were
included. Mean lesion size was 28.4mm (SD±12.3mm), with the majority
located in the head of the pancreas (n=89, 66%) and adenocarcinoma at
cytology/histology (61%). Regarding the primary endpoint, 2 passes were
performed in 95 (70.4%) patients whereas 3 passes in 40 (29.6%).
Sensitivity of detection did not increase with increasing number of passes
[86/95, 90.5% vs. 36/40, 90%, p=0.9]. In the secondary analysis, diagnostic
yield was independent of patient's age and gender, lesion size and location,
needle size, as well as Endoscopy department conducting the procedure.
Conclusion:
In a retrospective study, 2 passes of EUS-FNA were found to
be sufficient for the diagnosis of solid pancreatic masses; increasing the
number of passes did not increase sensitivity of detection.
Disclosure: None declared.
Contact E-Mail Address: 18795883826@163.com
Introduction: In recent years, Endoscopic submucosal dissection（ESD）
has been widely used in the treatment of early stage esophageal squamous
cell carcinoma (ESCC). Its indication is that esophageal lesions are
confined to the mucosa (EP/LPM) to the superficial submucosa (SM1).
Preoperative assessment of the invasion depth of ESCC is a necessary to
guide ESD. Magnifying endoscopy with blue laser imaging (ME-BLI) combined
with Endoscopic ultrasound (EUS) are widely used in preoperative
assessment of the invasion depth of ESCC. Since the new JES classification
was proposed in 2017, the judgment of ME-BLI in the depth of ESCC
has been simplified and what follows is the insufficient diagnostic power
of B2 blood vessels.
Aims & Methods: This study intends to explore the factors that affect
the accuracy of the diagnosis of ESCC invasion depth by type B2 vessels
through ME-BLI and analyze the risk factors of overdiagnosis and underdiagnosis.
Retrospectively analyze the clinical data of ESCC patients who underwent
ESD treatment in our hospital from January 2013 to September
2020, comparing to the postoperative pathology, calculate the diagnostic
efficacy of ME-BLI for type B2 blood vessels under the JES AB classification
and calculate the agreement rate, overdiagnosis rate and underdiagnosis
rate of preoperative and postoperative invasion depth staging.
Results: A total of 106 (118 lesions in total) ESCC patients were included
in this study, of which 38 (32.20%) patients with postoperative pathological
invasion depth of EP/LPM, 64(54.24%) patients with MM/SM1
and 16 (13.56%) cases≥SM2. A total of 52 (44.07%) lesions were ≤20mm
in diameter, 19 (36.54%) lesions were associated with overdiagnosis, 31
(59.61%) lesions had the same postoperative depth as preoperatively,
and 2 (3.85%) lesions were associated with underdiagnosis; A total of 66
(55.93%) lesions were larger than 20mm in diameter, of them 19 (28.79%)
lesions were associated with overdiagnosis, 33 (50.00%) lesions had the
same postoperative depth as preoperatively, and 14 (21.21%) lesions were
associated with underdiagnosis. The chi-square test found that the proportion
of underdiagnosed lesions in the diameter>20mm group was significantly
higher than that in the lesion diameter ≤20mm group (c2=7.484,
P=0.006). Among 61 lesions judged to be B2-Narrow endoscopically, 26
(42.62%) lesions were associated with overdiagnosis, 30 (49.18%) lesions
had the same depth after ESD as preoperatively, and 5 (8.20%) lesions are
associated with underdiagnosis; among 57 lesions that were judged to be
B2-Broad endoscopically, 12 (21.05%) of the lesions were associated with
overdiagnosis, 34 (59.65%) of the lesions had the same depth after ESD
as before, and 11 (19.30%) lesions are associated with underdiagnosis.
Chi-square test found that the proportion of over-diagnosed lesions in the
B2-Narrow group was significantly higher than that in the B2-Broad group
(c2=6.28, P=0.012). Multivariate logistics regression found that lesion diameter>
20mm is an independent risk factor for underdiagnosing the invasion
depth of lesions, which increases the risk of pathological escalation
after ESD by 6.231 times. B2-Broad type blood vessel is a protective factor
for postoperative pathological degradation (B=-0.902).
Conclusion: Lesion diameter> 20mm is an independent risk factor for
pathological escalation after ESD, B2-Broad type blood vessel is a protective
factor for overdiagnosis, suggesting that B2-Broad blood vessel is easier
to accurately determine the invasion depth of ESCC in type B2 blood vessel.
Disclosure: Nothing to disclose.
Vol. 9 | October 2021
767
UEGJournal Abstracts 2021

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