Role of macroscopic on-site evaluation of endoscopic ultrasoundguided fine-needle aspiration/biopsy:Results of a multicentric prospective study  

作　　者：Hussein H Okasha Hiwa A Hussein Khaled M Ragab Omar Abdallah Fedoua Rouibaa Borahma Mohamed Fahd Ghalim Mahmoud Farouk Mohamed Lasheen Mohamed A Elbasiony Ahmed E Alzamzamy Ahmed El Deeb Hassan Atalla Mahmoud El-Ansary Sahar Mohamed Moaz Elshair Wafaa Khannoussi Mohamed Z Abu-Amer Amine Elmekkaoui Mohammed S Naguib Adil Ait Errami Ahmed El-Meligui Ahmed H El-Habashi Mahmoud G Ameen Dalia Abdelfatah Mona Kaddah Hanane Delsa 

机构地区：[1]Division of Gastroenterology and Hepatology,Department of Internal Medicine,Kasr Al-Aini School of Medicine,Cairo University,Cairo 11562,Egypt [2]Sulaimani Center for Advanced Gastrointestinal Endoscopy,Sulaimani College of Medicine,Sulaymaniyah 46001,Iraq [3]Department of Hepatology and Gastroenterology,Theodor Bilharz Research Institute,Cairo 11211,Egypt [4]Hepatology and Gastroenterology Unit,Department of Internal Medicine,Mansoura University,Faculty of Medicine,Mansoura 35516,Egypt [5]Gastrointestinal Endoscopy Center,Military Hospital Mohamed V,Faculty of Medicine of Rabat,Rabat 10100,Rabat-Salé-Kénitra,Morocco [6]Department of Gastroenterology“C”,Ibn Sina Hospital,Mohammed V University in Rabat,Rabat 10000,Rabat-Salé-Kénitra,Morocco [7]Digestive Endoscopy Unit,Mekka Clinic,Casablanca 20000,Casablanca-Settat,Morocco [8]Department of Tropical Medicine and Gastroenterology,Luxor University,Luxor 85951,Egypt [9]Hepatology and Gastroenterology Unit,Department of Internal Medicine,Faculty of Medicine,Mansoura University,Mansoura 35516,Egypt [10]Department of Gastroenterology and Hepatology,Maadi Armed Forces Medical Complex,Military Medical Academy,Cairo 11841,Egypt [11]Department of Gastroenterology,National Hepatology and Tropical Medicine Research Institute,Cairo 12556,Egypt [12]Department of Hepatology,Gastroenterology and Infectious Diseases,Faculty of Medicine,Al-Azhar University,Cairo 11651,Egypt [13]Department of Gastroenterology and Endoscopy Center,Cheikh Khalifa International University Hospital,Mohammed VI University of Sciences and Health,Casablanca 82403,Casablanca-Settat,Morocco [14]Research Unit,Mohammed VI Center for Research and Innovation,Rabat 10100,Rabat-Salé-Kénitra,Morocco [15]Department of Hepato-Gastroenterology,Hassan II University Hospital of Fez,Faculty of Medicine,Pharmacy and Dentistry of Fez,Sidi Mohamed Ben Abdellah University,Fes 30003,Fès-Meknès,Morocco [16]Department of Gastroenterology,Ahmed Maher Teaching Hospital,Cairo 11451,Egypt [17]Department of Gastroenter

出　　处：《World Journal of Gastrointestinal Endoscopy》2024年第11期595-606,共12页世界胃肠内镜杂志（英文）

摘　　要：BACKGROUND The concept of macroscopic on-site evaluation(MOSE)was introduced in 2015 when the endoscopist observed better diagnostic yield when the macroscopically visible core on MOSE was superior to 4 mm.Recent studies suggest that MOSE by the endoscopist may be an excellent alternative to rapid on-site evaluation,and some classi-fications have been published.Few studies have assessed the adequacy of histologic cores in MOSE during endoscopic ultrasound-guided fine-needle aspiration/biopsy(EUS-FNA/FNB).AIM To evaluate the performance of MOSE during EUS-FNA/FNB.METHODS This multicentric prospective study was conducted in 16 centers in 3 countries(Egypt,Iraq,and Morocco)and included 1108 patients with pancreatic,biliary,or gastrointestinal pathology who were referred for EUS examination.We prospectively analyzed the MOSE in 1008 patients with available histopathological reports according to 2 classifications to determine the adequacy of the histological core samples.Data management and analysis were performed using a Statistical Package for Social Sciences(SPSS)version 27.RESULTS A total of 1074 solid lesions were biopsied in 1008 patients with available cytopathological reports.Mean age was 59 years,and 509 patients(50.5%)were male.The mean lesion size was 38 mm.The most frequently utilized needles were FNB-Franseen(74.5%)and 22 G(93.4%),with a median of 2 passes.According to 2 classifications,618 non-bloody cores(61.3%)and 964 good samples(95.6%)were adequate for histological evaluation.The overall diagnostic yield of cytopathology was 95.5%.The cytological examination confirmed the diagnosis of malignancy in 861 patients(85.4%),while 45 samples(4.5%)were inconclusive.Post-procedural adverse events occurred in 33 patients(3.3%).Statistical analysis showed a difference between needle types(P=0.035)with a high sensitivity of FNB(97%).The analysis of the relationship between the MOSE-score and the final diagnosis showed a significant difference between the different scores of the MOSE(P<0.001).CONCLUSION MOSE is a

关 键 词：Macroscopic on-site evaluation Fine-needle aspiration Fine-needle biopsy Endoscopic ultrasound SPECIMEN 

分 类 号：R57[医药卫生—消化系统] R65[医药卫生—内科学]