教員業績データベース |
|
論文種別 | 原著 |
言語種別 | 英語 |
査読の有無 | 査読なし |
表題 | Impact of EUS-FNA for preoperative para-aortic lymph node staging in patients with pancreatobiliary cancer |
掲載誌名 | 正式名:Gastrointestinal endoscopy 略 称:Gastrointest Endosc ISSNコード:1097-6779(Electronic)0016-5107(Linking) |
掲載区分 | 国外 |
巻・号・頁 | 84(3),pp.467-75.e1 |
著者・共著者 | Kurita Akira, Kodama Yuzo, Nakamoto Yuji, Isoda Hiroyoshi, Minamiguchi Sachiko, Yoshimura Kenichi, Kuriyama Katsutoshi, Sawai Yugo, Uza Norimitsu, Hatano Etsuro, Uemoto Shinji, Togashi Kaori, Haga Hironori, Chiba Tsutomu |
発行年月 | 2016/09 |
概要 | BACKGROUND AND AIMS:In patients with pancreatobiliary cancer, para-aortic lymph node (PALN) metastasis is considered to be the involvement beyond the regional lymph nodes, namely, distant metastasis. Effective methods for preoperative PALN staging, howeverBACKGROUND AND AIMS:, are not established. This study aimed to compare the diagnostic capability for PALN metastasis between EUS-FNA and (18)F-fluorodeoxyglucose positron emission tomography with CT (PET/CT).METHODS:We performed a prospective, nonrandomized, single-center trial. Between December 2010 and March 2014, 208 patients with pancreatobiliary cancer without apparent distant metastasis except for PALNs were assessed for study eligibility before surgery. Among them, 52 consecutive patients with PALN enlargement were enrolled in the study. (18)F-Fluorodeoxyglucose PET/CT and EUS-FNA were performed sequentially as a single combined procedure to evaluate PALN metastases. The primary outcome was to compare the diagnostic capability of EUS-FNA and PET/CT for PALN metastasis.RESULTS:Of 71 enlarged PALNs in the 52 patients, 30 (42.3%) were finally diagnosed as metastases in 21 patients (40.4%). Of the 21 patients with PALN metastases, preoperative EUS-FNA or PET/CT made a correct diagnosis in 20 (95.2%) or 12 (57.1%), respectively. EUS-FNA had higher sensitivity and specificity for the diagnosis of PALN metastasis (sensitivity, 96.7% [29/30RESULTS:]RESULTS:; 95% confidence interval, 82.2%-99.9%; specificity, 100% [39/39RESULTS:]RESULTS:; 95% confidence interval, 91.0%-100%) than PET/CT.CONCLUSIONS:EUS-FNA is superior to PET/CT for preoperative PALN staging in patients with pancreatobiliary cancer. Because of the clinical benefit of EUS-FNA to reduce unnecessary surgery, it should be part of the standard preoperative examination for patients with pancreatobiliary cancer. (UMIN clinical trials registry number: 000006408.). |
DOI | 10.1016/j.gie.2016.02.045 |
PMID | 26970011 |