Martin-Cardona, AFernandez-Esparrach, GSubtil, J CIglesias-Garcia, JGarcia-Guix, MBarturen Barroso, AGimeno-Garcia, A ZEsteban, J MPardo Balteiro, AVelasco-Guardado, AVazquez-Sequeiros, ELoras, CMartinez-Moreno, BCastellot, AHuertas, CMartinez-Lapiedra, MSanchez-Yague, ATeran, AMorales-Alvarado, V JBetes, Mde la Iglesia, DSánchez-Montes, CLozano, M DLariño-Noia, JGines, ATebe, CGornals, J BOn belhaf of Spanish Group for EUS-Guided TA in the adrenal gland2025-01-072025-01-072019-06-06https://hdl.handle.net/10668/26717There 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.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/Adrenal Gland NeoplasmsAdrenal GlandsAgedEndoscopic Ultrasound-Guided Fine Needle AspirationFemaleHumansMaleMultivariate AnalysisRetrospective StudiesSafetyresearch article31170163open access10.1371/journal.pone.02166581932-6203PMC6553722https://doi.org/10.1371/journal.pone.0216658https://pmc.ncbi.nlm.nih.gov/articles/PMC6553722/pdf