Preliminary Results of Macroscopic On-Site Evaluation in Pancreatic Lesions: A Prospective Multicenter Study

H Delsa; E Ghoneem; H Hiwa; K Ragab; O Abdallah; R Fedoua; M Borahma; F Ghalim; M Farouk; M Lasheen; M Elbasiony; A Elsayed Alzamzamy; A El Deeb; H Atalla; M El-Ansary; S Mohamed; M Elshair; W Khannoussi; M Abu-Amer; A Elmekkaoui; M Sherif Naguib; A E adil; A El-Meligui; A El-Habashi; M Gamal Ameen; I Benelbardhadi; D Abdelfatah; M Kaddah; H H Okasha

doi:10.1055/s-0045-1805543

Endoscopy, Table of Contents

Endoscopy 2025; 57(S 02): S221
DOI: 10.1055/s-0045-1805543

Abstracts | ESGE Days 2025

Moderated poster

EUS guided tissue acquisition: Needles and techniques 04/04/2025, 10:00 – 11:00 Poster Dome 1 (P0)

Preliminary Results of Macroscopic On-Site Evaluation in Pancreatic Lesions: A Prospective Multicenter Study

H Delsa

¹Cheikh Khalifa International University Hospital, Mohammed VI University of Sciences and Health, Casablanca, Morocco

²Gastroenterology, Mohammed VI University of Sciences and Health, Casablanca, Morocco

,

E Ghoneem

³Gastroenterology and Hepatology, Internal Medicine Department, Mansoura University, Mansoura, Egypt

,

H Hiwa

⁴Sulaimani Center for Advanced Gastrointestinal Endoscopy, Sulaymaniy, Iraq

,

K Ragab

⁵Gastroenterology, Theodor Bilharz Research Institute, cairo, Egypt

,

O Abdallah

⁶Mansoura University, Mansoura, Egypt

,

R Fedoua

⁷Mohamed V Military training hospital, Rabat, Morocco

,

M Borahma

⁸Department of Gastroenterology C, Hospital Ibn Sina, Rabat, Morocco

,

F Ghalim

⁹Digestive Endoscopy Unit, Mekka Clinic, Casablanca, Morocco

,

M Farouk

¹⁰Department of Tropical Medicine and Gastroenterology, Luxor University, Luxor, Egypt

,

M Lasheen

⁵Gastroenterology, Theodor Bilharz Research Institute, cairo, Egypt

,

M Elbasiony

⁶Mansoura University, Mansoura, Egypt

,

A Elsayed Alzamzamy

¹¹Military Medical Academy, Cairo, Egypt

,

A El Deeb

¹²National Hepatology and Tropical Medicine Research Institute, cairo, Egypt

,

H Atalla

⁶Mansoura University, Mansoura, Egypt

,

M El-Ansary

⁵Gastroenterology, Theodor Bilharz Research Institute, cairo, Egypt

,

S Mohamed

¹²National Hepatology and Tropical Medicine Research Institute, cairo, Egypt

,

M Elshair

¹³Faculty of Medicine, Al-Azhar University, cairo, Egypt

,

W Khannoussi

²Gastroenterology, Mohammed VI University of Sciences and Health, Casablanca, Morocco

,

M Abu-Amer

¹³Faculty of Medicine, Al-Azhar University, cairo, Egypt

,

A Elmekkaoui

¹⁴CHU HASSAN II FES, Fes, Morocco

,

M Sherif Naguib

¹⁵Department of Gastroenterology, Ahmed Maher Teaching Hospital, Cairo, Egypt

,

A E adil

¹⁶MOHAMMED VI UNIVERISTY HOSPITAL, Marrakech, Morocco

,

A El-Meligui

¹⁷Kasr Al-Aini School of Medicine, Cairo University, cairo, Egypt

,

A El-Habashi

¹⁸Department of Pathology, National Cancer Institute, Cairo University, cairo, Egypt

,

M Gamal Ameen

¹⁹Oncological Pathology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt

,

I Benelbardhadi

²Gastroenterology, Mohammed VI University of Sciences and Health, Casablanca, Morocco

,

D Abdelfatah

²⁰Department of Cancer Epidemiology and Biostatistics, National Cancer Institute, Cairo University, cairo, Egypt

,

M Kaddah

²¹Department of Endemic Medicine Faculty of Medicine, Cairo University, cairo, Egypt

,

H H Okasha

²²Internal Medicine Department, Division of Gastroenterology, Kasr Al-Aini School of Medicine, Cairo, Egypt

› Author Affiliations

Abstract

Full Text

Aims The aim of our study is to evaluate the performance of macroscopic on-site evaluation (MOSE) during endoscopic ultrasound-guided fine needle aspiration/biopsy (EUS-FNA/FNB) for pancreatic lesions.

Methods Over one year, we conducted a multicentic prospective study across 16 centers in three countries (Egypt, Iraq, and Morocco), involving 1008 patients referred for endoscopic ultrasound (EUS). We analyzed their MOSE of EUS-FNA/FNB using two different classifications to assess the adequacy of histological core samples. A total of 664 patients with pancreatic lesions were included in the study. Data management and analysis were performed using the Statistical Package for the Social Sciences (SPSS) version 27.

Results In 664 patients with pancreatic lesions, a total of 707 lesions were biopsied. Of the patients, 344 (51.8%) were male, and the mean age was 60 years. The average lesion size was 39 mm. The most commonly used needles were FNB-Franseen (73.6%) and 22 G (93.4%), with a median of 2 passes. Based on two classifications, 618 non-bloody cores (61.3%) and 964 adequate samples (95.6%) were considered suitable for histological evaluation. The overall diagnostic yield of cytopathology was 95.5%, with cytology confirming malignancy in 861 patients (85.4%) and 45 specimens (4.5%) being inconclusive. Post-procedural adverse events were reported in 33 patients (3.3%). Statistical analysis demonstrated the high sensitivity of FNB and a correlation between the MOSE score and the final diagnosis.

Conclusions Pancreatic lesions are challenging to biopsy, but good MOSE cores predict high accuracy. Our study confirmed the higher sensitivity of FNB and the increased diagnostic yield of cytopathology with good MOSE scores.