%0 Journal Article
%A Martin-Cardona, A
%A Fernandez-Esparrach, G
%A Subtil, J C
%A Iglesias-Garcia, J
%A Garcia-Guix, M
%A Barturen Barroso, A
%A Gimeno-Garcia, A Z
%A Esteban, J M
%A Pardo Balteiro, A
%A Velasco-Guardado, A
%A Vazquez-Sequeiros, E
%A Loras, C
%A Martinez-Moreno, B
%A Castellot, A
%A Huertas, C
%A Martinez-Lapiedra, M
%A Sanchez-Yague, A
%A Teran, A
%A Morales-Alvarado, V J
%A Betes, M
%A de la Iglesia, D
%A Sánchez-Montes, C
%A Lozano, M D
%A Lariño-Noia, J
%A Gines, A
%A Tebe, C
%A Gornals, J B
%A On belhaf of Spanish Group for EUS-Guided TA in the adrenal gland
%T EUS-guided tissue acquisition in the study of the adrenal glands: Results of a nationwide multicenter study.
%D 2019
%U https://hdl.handle.net/10668/26717
%X There are limited data about the role of endoscopic ultrasound-guided tissue acquisition (EUS-TA), by fine needle aspiration (EUS-FNA) or biopsy (EUS-FNB), in the evaluation of the adrenal glands (AG). The primary aim was to assess the diagnostic yield and safety. The secondary aims were the malignancy predictors, and to create a predictive model of malignancy. This was a retrospective nationwide study involving all Spanish hospitals experienced in EUS-TA of AGs. Inclusion period was from April-2003 to April-2016. Inclusion criteria: all consecutive cases that underwent EUS-TA of AGs. EUS and cytopathology findings were evaluated. Statistical analyses: diagnostic accuracy of echoendoscopist's suspicion using cytology by EUS-TA, as gold standard; multivariate logistic regression model to predict tumor malignancy. A total of 204 EUS-TA of AGs were evaluated. Primary tumor locations were lung70%, others19%, and unknown11%. AG samples were adequate for cytological diagnosis in 91%, and confirmed malignancy in 60%. Diagnostic accuracy of the endosonographer's suspicion was 68%. The most common technique was: a 22-G (65%) and cytological needle (75%) with suction-syringe (66%). No serious adverse events were described. The variables most associated with malignancy were size>30mm (OR2.27; 95%CI, 1.16-4.05), heterogeneous echo-pattern (OR2.11; 95%CI, 1.1-3.9), variegated AG shape (OR2.46; 95%CI, 1-6.24), and endosonographer suspicion (OR17.46; 95%CI, 6.2-58.5). The best variables for a predictive multivariate logistic model of malignancy were age, sex, echo-pattern, and AG-shape. EUS-TA of the AGs is a safe, minimally invasive procedure, allowing an excellent diagnostic yield. These results suggest the possibility of developing a pre-EUS procedure predictive malignancy model.
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