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<p>Lymph node sampling with endoscopic ultrasound fine needle aspiration (EUS-FNA) may affect treatment options for biliary tract cancers. Our aim is to clarify its utility and clinical significance and the factors associated with FNA cytology positivity. Seventy-one consecutive patients with biliary tract cancer who underwent EUS-FNA to diagnose lymphadenopathies from April 2012 to July 2021 were enrolled retrospectively. Lymph nodes with a short diameter over 10&#xa0;mm and/or fluorodeoxyglucose uptake were considered FNA targets. Samples eligible for cytology were attained in 70 patients with no complications. The FNA cytology-positive rate was 54%. In 35 patients with difficulty in obtaining pathological proof from primary tumors, obtaining a pathological diagnosis was successful in 24 patients. Thirteen of 16 FNA cytology-positive patients who were diagnosed with preoperative regional lymph node metastasis received chemotherapy prior to surgery. All seven FNA cytology-positive patients who were diagnosed with distant metastasis received systemic chemotherapy. Multivariate analyses showed a neutrophil-to-lymphocyte ratio over 2.5 (odds ratio (OR) 4.69, <i>p</i> = 0.04), fluorodeoxyglucose uptake (OR 5.34, <i>p</i> = 0.014), and a short diameter over 10.6&#xa0;mm (OR 6.11, <i>p</i> = 0.018) as factors related to FNA cytology positivity. EUS-FNA of lymphadenopathies in biliary tract cancers may affect clinical biliary tract cancer strategies.</p>

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Utility and clinical significance of endoscopic ultrasound-guided tissue acquisition for diagnosing lymphadenopathies in biliary tract cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月27日

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  • Katsuhiko Sato,
  • Minoru Shigekawa,
  • Syuhei Yamamoto,
  • Takayuki Matsumae,
  • Yu Sato,
  • Teppei Yoshioka,
  • Takahiro Kodama,
  • Hayato Hikita,
  • Tomohide Tatsumi,
  • Tetsuo Takehara

摘要

Lymph node sampling with endoscopic ultrasound fine needle aspiration (EUS-FNA) may affect treatment options for biliary tract cancers. Our aim is to clarify its utility and clinical significance and the factors associated with FNA cytology positivity. Seventy-one consecutive patients with biliary tract cancer who underwent EUS-FNA to diagnose lymphadenopathies from April 2012 to July 2021 were enrolled retrospectively. Lymph nodes with a short diameter over 10 mm and/or fluorodeoxyglucose uptake were considered FNA targets. Samples eligible for cytology were attained in 70 patients with no complications. The FNA cytology-positive rate was 54%. In 35 patients with difficulty in obtaining pathological proof from primary tumors, obtaining a pathological diagnosis was successful in 24 patients. Thirteen of 16 FNA cytology-positive patients who were diagnosed with preoperative regional lymph node metastasis received chemotherapy prior to surgery. All seven FNA cytology-positive patients who were diagnosed with distant metastasis received systemic chemotherapy. Multivariate analyses showed a neutrophil-to-lymphocyte ratio over 2.5 (odds ratio (OR) 4.69, p = 0.04), fluorodeoxyglucose uptake (OR 5.34, p = 0.014), and a short diameter over 10.6 mm (OR 6.11, p = 0.018) as factors related to FNA cytology positivity. EUS-FNA of lymphadenopathies in biliary tract cancers may affect clinical biliary tract cancer strategies.