Acta cytologica · 2024
Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Pancreatic Neuroendocrine Tumors with Rapid On-Site Evaluation: Single-Center Experience.
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Bakkaloglu Irem Guvendir, Gurbuz Begum Calim, Sahin Onur, Zemheri Itir Ebru
Аннотация
INTRODUCTION: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a highly sensitive and accurate method for identifying pancreatic neuroendocrine tumors (PanNETs). However, research on grading and assessing the Ki67 proliferation index in FNA samples is limited.
METHODS: This study analyzed 335 EUS-FNA cases performed between 2016 and 2022, of which 12 cases of PanNET were further evaluated. The morphology, Ki-67 index, and grading (G) of cell blocks (CBs) obtained from the PanNET aspirations were compared to those of the resected material.
RESULTS: Out of 12 PanNET's with rapid on-site evaluation (ROSE), in FNA samples and CB, 7 (58.3%) cases were G1, while 5 (41.7%) cases were G2. On the other hand, on resection of these cases, 6 (50%) were diagnosed as G1, 5 (41.7%) cases were G2, and 1 case (8.3%) was G3. The average Ki-67 index in CB was 2.92 (min: 1 - max: 10), while in resections it was 4.67 (min: 1 - max: 22). Only 2 (16.6%) showed a discordance between grade and Ki-67, resulting in an overall concordance of over 80%. On average, 1.83 needle passes were made (range: 1-3), while the average number of slides and CBs were 9.33 (range: 1-24) and 2.17 (range: 1-6), respectively. There were no significant differences in the number of passes, slides, or CBs between the consistent and discordant groups.
CONCLUSION: Optimal counting techniques and sensitivity for Ki67 are crucial in grading PanNETs in both aspiration and resection materials. The grade and Ki-67 index demonstrated high concordance when comparing CB and resection. However, in low-volume centers, ROSE support can be beneficial in obtaining sufficient slides and CB for an adequate diagnosis.
METHODS: This study analyzed 335 EUS-FNA cases performed between 2016 and 2022, of which 12 cases of PanNET were further evaluated. The morphology, Ki-67 index, and grading (G) of cell blocks (CBs) obtained from the PanNET aspirations were compared to those of the resected material.
RESULTS: Out of 12 PanNET's with rapid on-site evaluation (ROSE), in FNA samples and CB, 7 (58.3%) cases were G1, while 5 (41.7%) cases were G2. On the other hand, on resection of these cases, 6 (50%) were diagnosed as G1, 5 (41.7%) cases were G2, and 1 case (8.3%) was G3. The average Ki-67 index in CB was 2.92 (min: 1 - max: 10), while in resections it was 4.67 (min: 1 - max: 22). Only 2 (16.6%) showed a discordance between grade and Ki-67, resulting in an overall concordance of over 80%. On average, 1.83 needle passes were made (range: 1-3), while the average number of slides and CBs were 9.33 (range: 1-24) and 2.17 (range: 1-6), respectively. There were no significant differences in the number of passes, slides, or CBs between the consistent and discordant groups.
CONCLUSION: Optimal counting techniques and sensitivity for Ki67 are crucial in grading PanNETs in both aspiration and resection materials. The grade and Ki-67 index demonstrated high concordance when comparing CB and resection. However, in low-volume centers, ROSE support can be beneficial in obtaining sufficient slides and CB for an adequate diagnosis.