A novel approach to the diagnosis of pancreatic serous cystadenoma: needle-based confocal laser endomicroscopy

• DOI: 10.1055/s-0034-1390693
• Publication Date: 2014-10-17T22:34:14Z
• Authors: Bertrand Napoléon; Anne-Isabelle Lem...; Bertrand Pujol; Fabrice Caillol; Damien Lucidarme; Raphaël Bourdariat; Blandine Morellon...; Fabien Fumex; Christine Lefort; Vincent Lepilliez; Laurent Palazzo; Geneviève Monges; Bernard Filoche; Marc Giovannini
• Keywords: Serous Cystadenoma; Cytopathology; Gold standard (test); Mucinous cystadenoma; Endoscopic Ultrasound

<b>Background and study aims:</b> The differential diagnosis of solitary pancreatic cystic lesions is frequently difficult. Needle-based confocal laser endomicroscopy (nCLE) performed during endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) a new technology enabling real-time imaging the internal structure such cysts. aim this pilot was to identify validate diagnostic criteria on nCLE for lesions. <b>Patients methods:</b> A total 31 patients with lesion unknown were prospectively included at three centers. EUS-FNA combined nCLE. final based either stringent gold standard (surgical specimen and/or positive cytopathology) or committee consensus. Six nonblinded investigators reviewed sequences from most diagnosis, identified single feature that only present in serous cystadenoma (SCA). findings correlated pathology archived specimens. After training session, four blinded independent observers separate video set, yield interobserver agreement criterion assessed. <b>Results:</b> superficial vascular network pattern visualized as criterion. It corresponded pathological dense subepithelial capillary vascularization seen SCA. accuracy, sensitivity, specificity, predictive value, negative value sign SCA 87 %, 69 100 82 respectively. Interobserver substantial (κ = 0.77). <b>Conclusion:</b> This seems highly specific visualization could have direct impact management by avoiding unnecessary surgery follow-up. Clinicaltrials.gov NCT01563133.