E.G. Solonitsyn
Almazov National Medical Research Center
V.F. Kamalova
Almazov National Medical Research Centre
L.B. Mitrofanova
Almazov National Medical Research Centre
Endoscopic ultrasonography and endoscopic ultrasonography with fine needle aspiration in the diagnosis of neuroendocrine neoplasms of the pancreas
Journal: Endoscopic Surgery. 2023;29(6): 19‑27
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To cite this article:
Solonitsyn EG, Poddymova AV, Kamalova VF, Shestopalova TM, Mitrofanova LB, Seyfedinova SSh, Shpomer AA. Endoscopic ultrasonography and endoscopic ultrasonography with fine needle aspiration in the diagnosis of neuroendocrine neoplasms of the pancreas. Endoscopic Surgery.
2023;29(6):19‑27. (In Russ., In Engl.)
https://doi.org/10.17116/endoskop20232906119
Endoscopic ultrasonography (EUS) and endoscopic ultrasonography with fine needle aspiration (EUS-FNA) are among the methods of the diagnosis and differential diagnosis of neuroendocrine tumors of the pancreas (pNET).
The purpose of our work is to analyze the results of EUS and EUS-FNA in the preoperative diagnosis of patients with pNET and to compare them with the data of modern literature.
We retrospectively analyzed the results of EUS and EUS-FNA of morphologically confirmed pNET, which were performed in the period between February 2012 and December 2021. The study included 62 patients with localized forms and common neoplasms, including metastatic lesions of the lymph nodes and liver. We evaluated ultrasonographic and morphological characteristics of the detected neoplasms, including informative morphological conclusion.
We have analyzed performance of pNET diagnostics with the examples of EUS and EUS-FNA results in 62 patients. The EUS characteristics of the pNET were analyzed, as well as the results of the EUS-FNA. The average size of the neoplasms was 24±4.13 mm. The most frequent localization of pNET was the head of the pancreas — 21 cases (33.9%), then the body of the pancreas — 19 cases (30.6%), in 8 cases (12.9%) the lesions were localized in the tail of the pancreas, 2 cases (3.2%) manifested themselves on the wall of the duodenum. Multiple lesions occurred in 12 cases (19.3%). In 8% of cases, pNET had an atypical EUS picture, in 3 cases (5%) we detected a cystic form of neoplasia. The technical success of EUS-FNA was 100%. In 86.7%, the results of EUS-FNA were explicit, in 13.3% — doubtful. There were no vague EUS-FNA results. At the same time, in 57 cases (95%), IHC was performed, including the calculation of the index of proliferative activity Ki67. According to the Grade classification, the cases were distributed as follows: Grade 1 — 19 cases (34.9%), Grade 2 — 29 cases (53.3%), Grade 3 — 1 case (1.8%), neuroendocrine carcinoma — 10.1%.
EUS and EUS-FNA are effective methods of diagnosis, staging and morphological detection of pNET. This method should be included in the selection of diagnostic methods of pNET, especially in cases of surgical treatment.
Authors:
E.G. Solonitsyn
Almazov National Medical Research Center
V.F. Kamalova
Almazov National Medical Research Centre
L.B. Mitrofanova
Almazov National Medical Research Centre
Received:
25.09.2022
Accepted:
09.03.2023
List of references:
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