Diagnostic Accuracy and Safety of Endoscopic Ultrasound-Guided End-Cutting Fine-Needle Biopsy (FNB) Needles For Tissue Sampling of Abdominal and Mediastinal Lymphadenopathies: A Prospective Multicentre Series
Bibliographic record
Abstract
Aims The role of the newer EUS-fine needle biopsy (FNB) needles in lymphadenopathies (LA) is still underevaluation. We aimed to evaluate the diagnostic accuracy and the adverse event rate of EUS-FNB indiagnosing LA. Methods From June 2015 to 2022, all patients referred to 4 institutions for EUS-FNB of mediastinal and abdominal LAwere enrolled. 22G Franseen tip or 25G Sharkcore needles were used. The gold standard for positive resultswas surgery or imaging and clinical evolution over a follow-up of at least one year [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ] [ 6 ] [ 7 ] [ 8 ] [ 9 ] [ 10 ] [ 11 ] [ 12 ] [ 13 ] [ 14 ] [ 15 ] [ 16 ] [ 17 ] [ 18 ]. Results A total of 100 consecutive patients were enrolled, consisting of those with a new diagnosis of LA (40%),presence of LA with a previous history of neoplasia (51%), or suspected lymphoproliferative disease (9%).EUS-FNB was technically feasible in all LA patients with 2 to 3 passes (mean 2.62±0.93). The overall EUS-FNB sensitivity, positive predictive value (PPV), specificity, negative predictive value (NPV), and accuracy were96.20%, 100%, 100%, 87.50%, and 97.00%, respectively. Histological analysis was feasible in 89% of cases.Cytological evaluation was performed in 67% of specimens. There was no statistical difference between theaccuracy of the 22G or 25G needle (p=0.63). A sub-analysis on lymphoproliferative disease revealed asensitivity and accuracy of 89.29% and 90.0%. No complications were recorded. Conclusions EUS-FNB with new end-cutting needles is a valuable and safe method to diagnose LA. The high quality ofhistological cores and the good amount of tissue allowed a complete immunohistochemical analysis ofmetastatic LA and precise subtyping of the lymphomas. Publication History Article published online: 14 April 2023 © 2023. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".