The efficacy and safety of endoscopic ultrasound-guided fine-needle biopsy in gallbladder masses

Background: Endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB) is a widely used modality for acquiring various target samples, but its efficacy in gallbladder masses is unknown. The aim of this retrospective study was to evaluate the efficacy and safety of EUS-FNB in patients with gallbladder masses. Methods: The study samples were composed of patients from March 2015 to July 2019 who needed to identify the nature of gallbladder masses through EUS-FNB. The outcomes of this study were the adequacy of specimens, diagnostic yields, technical feasibility, and adverse events of the EUS-FNB in gallbladder masses. Results: A total of 27 consecutive patients with a median age of 58 years were included in this study. The 22-gauge FNB needle was feasible in all lesions. The median follow-up period of the patients was 294 days. The specimens sufficient for diagnosis account for 89%(24/27) and 93%(25/27) in cytology and histology, respectively. The overall diagnostic yields for malignancy showed the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.45% [95% confidence interval(CI): 75.12%-99.76%], 100%(95% CI: 46.29%-10 0%), 10 0%(95% CI: 80.76%-100%), 83.33%(95% CI: 36.48%-99.12%), and 96.30%(95% CI: 80.20%-99.99%), respectively. The subgroup analysis revealed that FNB could obtain sufficient specimens and high diagnostic yields in both gallbladder mass < 20.5 mm group and ≥20.5 mm group. One patient experienced mild abdominal pain after the procedure and recovered within one day. Conclusions: EUS-FNB is a reasonable diagnostic tool for the pretreatment diagnosis of patients with gallbladder masses, especially for patients who may miss the opportunity of surgery and need sufficient specimens to identify the pathological type so as to determine chemotherapy regimens. Further largescale studies are needed to confirm our conclusion.

Combining Endometrium Sampling Device and SurePath Preparation to Screen for Endometrial Carcinoma： A Validation Study

Background：The aim of this study was to compare specimen adequacy of SAP-I provided for cytology with that of dilation and curettage （D ＆ C） or hysteroscopy for histology,and evaluate the accuracy of combining endometrium sampling by SAP-1 and liquid-based cytology using SurePath preparation for screening endometrial carcinoma and its precursor.Methods：Endometrial specimens from women （n =1514） with risk factors were obtained using an SAP-l device for cytological analysis; histological samples were obtained from 375 of these women who underwent D ＆ C or hysteroscopy.Cytological specimens were prepared to liquid-based smear using SurePath technology and stained by Papanicolaou.Histological samples were processed in routine pathology and stained by hematoxylin and eosin.Results：Adequate specimens for cytology were obtained from 1458/1541 patients （96.3%）,while adequate samples for pathology were obtained from 285/375 patients （76%）.However,for postmenopausaI women,1006 of 1045 cytology （86.3%） were adequate,153 of 238 histology （64.3%） were adequate,it was easier to collect cytological specimens than histological specimens （P 〈 0.05）.The accuracy of endometrial cytology for detecting endometrial carcinoma and its precursor was 92.4% （sensitivity,73%; specificity,95.8%; positive predictive value,75%; and negative predictive value,95.3%）.Conclusions：Endometrial cytology using SAP-1 sampling and SurePath preparation may be a reliable approach for screening patients with endometrial carcinoma and its precursor.