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Katipoglu K, Kilic I, Kurtulan O, Akdas Y, Barkan GA. A systematic review on performance characteristics of FNA of renal lesions: It is time for a standardized classification system. Cancer Cytopathol 2024. [PMID: 38713617 DOI: 10.1002/cncy.22826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/14/2024] [Accepted: 04/03/2024] [Indexed: 05/09/2024]
Abstract
BACKGROUND The incidence of renal tumors has steadily increased over the past decade. In this study, the authors performed a systematic review and analysis of the literature on renal fine-needle aspiration (FNA) to determine its performance and explore whether a standardized classification system can be used for reporting renal FNA cytology. METHODS A systematic search of published articles on renal FNA was conducted. The data on FNA and histologic diagnosis were extracted and categorized, and the risk of malignancy was calculated. Different scenarios were used to estimate FNA performance statistics. RESULTS Of the 3766 potentially relevant studies, 23 met the inclusion criteria of the study. The 2231 FNA cases included were re-categorized according to the classification system, rendering 142 (6.36%) nondiagnostic, 270 (12.1%) nonneoplastic, 271 (12.14%) benign neoplasm, 65 (2.91%) renal neoplasm with unknown malignant potential, oncocytic type, 25 (1.12%) atypia of undetermined significance, 60 (2.68%) suspicious for malignancy, and 1398 (62.66%) malignant FNA diagnoses. The risk of malignancy in these cases was 65.4%, 18.1%, 16.6%, 16.9%, 60%, 73.3%, and 96.9%, respectively. According to the classification system, the study indicated that the accuracy of renal FNA was between 91% and 95%, the sensitivity was 90.9%-96.7%, and the specificity was 82%-92% in different scenarios. CONCLUSIONS There is a need for a standardized reporting in renal cytology that will improve the sensitivity and accuracy of renal cytology, reduce the rate of indeterminate diagnoses, and alter the management strategies of renal lesions. Based on the available literature, a new reporting system is proposed, including categories with an associated risk of malignancy.
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Affiliation(s)
- Kübra Katipoglu
- Department of Pathology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Irem Kilic
- Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Olcay Kurtulan
- Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Yasemin Akdas
- Division of Emergency Medicine Research, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Güliz A Barkan
- Department of Pathology and Laboratory Medicine, Loyola University Healthcare System, Maywood, Illinois, USA
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Tang XP, Chen JF, Liu AQ, Shen YH, Huang YL. Clinical application of endoscopic ultrasonography in evaluation of colorectal and peri-colorectal lesions. Shijie Huaren Xiaohua Zazhi 2022; 30:647-654. [DOI: 10.11569/wcjd.v30.i14.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Endoscopic ultrasonography (EUS) has the functions of both endoscopy and ultrasound. Due to the complex anatomical structure of the intestine, there are few studies on EUS in colorectal lesions.
AIM To explore the clinical application value of EUS in the diagnosis of colorectal and peri-colorectal lesions.
METHODS We retrospectively analyzed the examination results of 95 patients detected by endoscopic miniprobe sonography (MPS) and linear EUS from September 2018 to July 2021, which were then compared to postoperative pathology. The kappa test was used in statistical analysis.
RESULTS Using postoperative pathology as the golden standard, the accuracy of linear EUS in diagnosing the depth of rectal cancer invasion (T stage) was 73.9% (17/23 cases), including T1 (2/4 cases), T2 (4/6 cases), T3 (6/7 cases) , and T4 (5/ 5 cases) stages. The accuracy of linear EUS in diagnosing regional lymph node metastasis (N stage) was 91.3% (21/23 cases), including N0 (14/15 cases) and N1 (7/8 cases) stages. The consistency was high (kappa value = 0.782, P < 0.01). During preoperative evaluation of colorectal adenoma or early cancer before endoscopic submucosal dissection (ESD), the accuracy of MPS in diagnosing the depth of tumor invasion was 87.1% (27/31 cases), and the consistency was moderate (kappa value = 0.665, P < 0.01). The accuracy of MPS in diagnosing the origin and type of colorectal submucosal lesions was 95.5% (21/22 cases), and the consistency was high (kappa value = 0.919, P < 0.01). The accuracy of endoscopic ultrasonography-guided fine-needle aspiration in determining rectal and peri-rectal lesions was 70.0% (7/10 cases), and the consistency was moderate (kappa value = 0.565, P < 0.01).
CONCLUSION According to the specific location and size of colorectal and peri-colorectal lesions, selective use of the MPS and linear EUS is of great value with regard to T/N staging of rectal cancer, preoperative evaluation of ESD, determination of the characteristics of colorectal-submucosal bulging lesions, and acquisition of lesion tissue of rectal and peri-rectal lesions.
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Affiliation(s)
- Xi-Ping Tang
- Guangxi Medical University Cancer Hospital, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Jin-Feng Chen
- Guangxi Medical University Cancer Hospital, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Ai-Qun Liu
- Guangxi Medical University Cancer Hospital, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Yan-Hua Shen
- Guangxi Medical University Cancer Hospital, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Yue-Li Huang
- Guangxi Medical University Cancer Hospital, Nanning 530021, Guangxi Zhuang Autonomous Region, China
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CT-Guided Percutaneous Needle Biopsy of Retroperitoneal and Pelvic Lymphadenopathy: Assessment of Technique, Diagnostic Yield, and Clinical Value. J Vasc Interv Radiol 2018; 29:1429-1436. [DOI: 10.1016/j.jvir.2018.03.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 11/23/2022] Open
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Zoller G, Langlois I, Alexander K. Glomerular filtration rate determination by computed tomography in two pet rabbits with renal disease. J Am Vet Med Assoc 2017; 250:681-687. [DOI: 10.2460/javma.250.6.681] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Han C, Lin R, Zhang Q, Liu J, Ding Z, Hou X. Role of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of mass lesions. Exp Ther Med 2016; 12:1085-1092. [PMID: 27446324 DOI: 10.3892/etm.2016.3433] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 03/30/2016] [Indexed: 12/14/2022] Open
Abstract
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an accurate technique for sampling the pancreas and mediastinum; however, limited data are available for other mass lesions. The aim of this study was to explore the value of EUS-FNA in the differential diagnosis of all mass lesions. Data from patients who underwent EUS-FNA for the diagnosis of mass lesions, including pancreatic, mediastinal, celiac and retroperitoneal lesions were retrospectively analyzed. The accuracy was calculated by comparing the results of FNA with the results of pathological examination or follow-up surveillances in non-operated cases. A total of 150 cases were included. The location of the mass varied from the pancreas (n=62) to the mediastinum (n=29), gastrointestinal tract (n=36), celiac cavity and retroperitoneum (n=23). The sensitivity and Youdens index of EUS-FNA in the diagnosis of all lesions were 92.97% and 0.93 respectively. The accuracy of diagnosis of pancreatic, mediastinal, gastrointestinal, celiac and retroperitoneal lesions was 85.48, 89.66, 83.33 and 78.23%, respectively. Masses were categorized into parenchymal organs (n=66), luminal organs (n=36) and enlarged lymph nodes (n=33). Lesions in parenchymal organs were likely to be bigger than those in luminal organs (P=0.03) and enlarged lymph nodes (P=0.01). For solid and cystic masses, which constituted 63.3 and 14.7% of the total masses, no significant difference in diagnostic accuracy was observed (P=0.56); however, lesion sizes were significantly different between these two groups (P=0.04) and the majority of cystic masses were identified in women (P=0.03). Malignant lesions were more common in older (P=0.01) and male (P=0.03) patients. In conclusion, EUS-FNA is an effective tool in the diagnosis of unexplained mass lesions; it influences the management of patients by enabling the appropriate treatment to be identified.
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Affiliation(s)
- Chaoqun Han
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Rong Lin
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Qin Zhang
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Jun Liu
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Zhen Ding
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Xiaohua Hou
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
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Han C, Lin R, Liu J, Hou X, Qian W, Ding Z. Endoscopic Ultrasonography-Guided Biopsy for Differentiation of Benign and Malignant Pelvic Lesions: A Systematic Review and Meta-Analysis. Dig Dis Sci 2015; 60:3771-81. [PMID: 26341351 DOI: 10.1007/s10620-015-3831-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 07/29/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Preoperative diagnosis of pelvic lesions remains challenging despite advances in imaging technologies. Endoscopic ultrasonography (EUS)-guided biopsy is an effective diagnostic modality for sampling the digestive tract and surrounding areas. However, a meta-analysis summarizing the diagnostic efficacy of EUS-guided biopsy for pelvic lesions has not been published. AIMS We aimed to evaluate the utility of EUS-guided biopsy in the diagnosis of pelvic lesions. METHODS Articles were identified via structured database search; only studies where pelvic lesions were confirmed by surgery or clinical follow-up were included. Data extracted were selected with strict criteria. A fixed-effects model was used to estimate the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). A summary receiver operating characteristic curve (SROC) was also constructed. RESULTS Ten studies containing a total of 246 patients were included. The pooled sensitivity of EUS-guided biopsy for differential diagnosis of pelvic masses was 0.89 (95% CI 0.83-0.94), and the specificity was 0.93 (95% CI 0.86-0.97). The area under the SROC was 0.9631. The combined PLR, NLR, and DOR were 11.75 (95% CI 5.90-23.43), 0.12 (95% CI 0.07-0.20), and 100.06 (95% CI 37.48-267.10) respectively. There is potential presence of publication bias in this meta-analysis. CONCLUSIONS Our meta-analysis shows that EUS-guided biopsy is a powerful tool for differentiating pelvic masses with a high sensitivity and specificity. Furthermore, it is a safe procedure with low rate of complication, although more high-quality prospective studies are required to be done.
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Affiliation(s)
- Chaoqun Han
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Rong Lin
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Jun Liu
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Xiaohua Hou
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Wei Qian
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Zhen Ding
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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