Maria Chiara Petrone1, Jan-Werner Poley2, Matteo Bonzini3, Ihab Abdulkader4, Katharina Biermann5, Genevieve Monges6, Guido Rindi7, Claudio Doglioni8, Marco J Bruno2, Marc Giovannini9, Julio Iglesias-Garcia10, Alberto Larghi11, Paolo Giorgio Arcidiacono1. 1. Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational & Clinical Research Center, Vita Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy. 2. Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands. 3. Department of Clinical Science and Community Health, Fondazione IRCCS Ospedale Maggiore Policlinico, University of Milan, Italy. 4. Pathology Department, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain. 5. Pathology Department, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands. 6. Pathology Department, Paoli-Calmettes Institut, Marseilles, France. 7. Institute of Anatomic Pathology, Catholic University, Rome. 8. Pathology Department, Vita Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy. 9. Endoscopic Unit, Paoli-Calmettes Institut, Marseilles, France. 10. Gastroenterology and Hepatology Department, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain. 11. Digestive Endoscopy Unit, Catholic University, Rome, Italy.
Abstract
BACKGROUND AND AIM: Scanty data about inter-observer agreement (IOA) among pathologists in the evaluation of pancreatic samples acquired with EUS histology needle are available. The aim of this study was to determine IOA on adequacy of pancreatic histology specimens obtained with a 22G needle by a panel of experienced pathologist, in comparison with the 19G needle. METHODS: This multicentre prospective study involved 73 pancreatic specimens prepared using histology needles of different calibres. Five pathologists independently reviewed all the samples, assessing the presence of a core, specimen adequacy and the possibility to perform additional analyses. IOA determined by Fleiss' Kappa statistic was used as the primary outcome measure. Secondary outcome was to compare 22G versus 19G needle results. RESULTS: A core was present in 57% of pancreatic specimens obtained by 22G needle. The specimens were considered adequate in 72% of cases, with poor agreement among pathologists (p = 0.02, Fleiss' κ = 0.26). The possibility to perform further analyses was rated as 'positive' in 66% of cases without significant difference among observers (p = 0.80). When comparing the results, the presence of a core and the adequacy of tissue slides were significantly better for the 19G needle (57% vs. 84% p = 0.002; 72% vs. 83% p = 0.004, respectively). Reproducibility in the assessment of pancreatic sample adequacy was significantly better with the 19G needle (κ = 0.26 for 22G samples vs. κ = 0.81 for 19G samples). CONCLUSIONS: Our results suggest that histology sampling of pancreatic masses should be performed with a 19G histology needle, since is able to provide a core in the majority of cases, with 83% of adequate specimens and excellent results in term of reproducibility among pathologists.
BACKGROUND AND AIM: Scanty data about inter-observer agreement (IOA) among pathologists in the evaluation of pancreatic samples acquired with EUS histology needle are available. The aim of this study was to determine IOA on adequacy of pancreatic histology specimens obtained with a 22G needle by a panel of experienced pathologist, in comparison with the 19G needle. METHODS: This multicentre prospective study involved 73 pancreatic specimens prepared using histology needles of different calibres. Five pathologists independently reviewed all the samples, assessing the presence of a core, specimen adequacy and the possibility to perform additional analyses. IOA determined by Fleiss' Kappa statistic was used as the primary outcome measure. Secondary outcome was to compare 22G versus 19G needle results. RESULTS: A core was present in 57% of pancreatic specimens obtained by 22G needle. The specimens were considered adequate in 72% of cases, with poor agreement among pathologists (p = 0.02, Fleiss' κ = 0.26). The possibility to perform further analyses was rated as 'positive' in 66% of cases without significant difference among observers (p = 0.80). When comparing the results, the presence of a core and the adequacy of tissue slides were significantly better for the 19G needle (57% vs. 84% p = 0.002; 72% vs. 83% p = 0.004, respectively). Reproducibility in the assessment of pancreatic sample adequacy was significantly better with the 19G needle (κ = 0.26 for 22G samples vs. κ = 0.81 for 19G samples). CONCLUSIONS: Our results suggest that histology sampling of pancreatic masses should be performed with a 19G histology needle, since is able to provide a core in the majority of cases, with 83% of adequate specimens and excellent results in term of reproducibility among pathologists.
Authors: Maria Chiara Petrone; Jan-Werner Poley; Matteo Bonzini; Pier Alberto Testoni; Ihab Abdulkader; Katharina Biermann; Genevieve Monges; Guido Rindi; Claudio Doglioni; Marco J Bruno; Marc Giovannini; Julio Iglesias-Garcia; Alberto Larghi; Paolo Giorgio Arcidiacono Journal: Histopathology Date: 2013-02-05 Impact factor: 5.087
Authors: J Ferlay; E Steliarova-Foucher; J Lortet-Tieulent; S Rosso; J W W Coebergh; H Comber; D Forman; F Bray Journal: Eur J Cancer Date: 2013-02-26 Impact factor: 9.162