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 25 November 2017

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News

Endoscopic lymph-node staging more accurate than routine criteria

Selective endoscopic ultrasound-guided fine-needle aspiration may avoid the need for aspiration with esophageal carcinoma, reduces costs, and is more accurate than standard criteria for staging, reports this month's Gastrointestinal Endoscopy.

News image

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Endoscopic ultrasound-guided fine-needle aspiration is the most accurate method for lymph-node staging of esophageal carcinoma.

However, it may not be necessary when endoscopic ultrasound features are present that strongly suggest a benign or a malignant origin.

Dr Enrique Vazquez-Sequeiros and colleagues from Minnesota identified endoscopic ultrasound criteria that have sensitivity and specificity to preclude the need for endoscopic ultrasound-guided fine-needle aspiration.

The research team also assessed the cost savings derived from a selective endoscopic ultrasound-guided fine-needle aspiration approach.

A total of 144 patients with esophageal carcinoma were prospectively evaluated with endoscopic ultrasound.

The team compared accuracy of standard, and modified criteria using 2 diagnostic strategies.

Endoscopic ultrasound selective approach may avoid performing fine-needle aspiration in 42%
Gastrointestinal Endoscopy

The researchers assessed all patients with lymph nodes in the routine strategy.

Endoscopic ultrasound-guided fine-needle aspiration was only used where the number of endoscopic ultrasound malignant criteria provided a sensitivity and a specificity less than 100%.

Modified endoscopic ultrasound criteria for lymph-node staging were more accurate than standard criteria.

The team noted that no criterion alone was predictive of malignancy.

Sensitivity and specificity reached 100% when a cutoff value of more than 1, or more than 6 modified criteria were used, respectively.

The endoscopic ultrasound-guided fine-needle aspiration selective approach may avoid performing fine-needle aspiration in 42% of patients.

Dr Vazquez-Sequeiros' team commented, “Modified endoscopic ultrasound lymph-node criteria are more accurate than standard criteria.”

“A selective endoscopic ultrasound-guided fine-needle aspiration approach reduced the cost by avoiding endoscopic ultrasound-guided fine-needle aspiration in 42% of patients with esophageal carcinoma.”

“These results require confirmation in future studies.”

Gastrointest Endoscopy 2006: 63(2): 204-11
06 February 2006

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