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Pancreatic Neoplasms: HELP
Articles by Erminia Manfrin
Based on 6 articles published since 2010
(Why 6 articles?)
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Between 2010 and 2020, Erminia Manfrin wrote the following 6 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Ultrasound-guided percutaneous fine-needle aspiration of solid pancreatic neoplasms: 10-year experience with more than 2,000 cases and a review of the literature. 2016

D'Onofrio, Mirko / De Robertis, Riccardo / Barbi, Emilio / Martone, Enrico / Manfrin, Erminia / Gobbo, Stefano / Puntel, Gino / Bonetti, Franco / Pozzi Mucelli, Roberto. ·Department of Radiology, G.B. Rossi Hospital, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy. · Department of Radiology, Casa di cura Pederzoli, Peschiera del Garda, Italy. riccardo.derobertis@hotmail.it. · Department of Radiology, Casa di cura Pederzoli, Peschiera del Garda, Italy. · Department of Pathology, G.B. Rossi Hospital, University of Verona, Verona, Italy. · Department of Pathology, Casa di cura Pederzoli, Peschiera del Garda, Italy. ·Eur Radiol · Pubmed #26373764.

ABSTRACT: OBJECTIVES: To evaluate the diagnostic accuracy and complication rate of percutaneous ultrasound-guided fine-needle aspiration (US-FNA) of solid pancreatic neoplasms through the analysis of 10-year experiences of two centres. METHODS: Clinical, radiological and pathologic data of 2,024 patients with solid pancreatic masses who underwent US-FNAs were retrospectively evaluated. Indications for aspiration were: unresectable lesions before neo-adjuvant therapy; doubtful imaging findings; and suspicion of uncommon neoplasms with prognostic or therapeutic implications such as metastases or lymphoma. US-FNAs were performed using aspiration needles with a cytopathologist present in centre 1. In centre 2, cytologic samples were collected with Chiba needles and separately evaluated by a cytopathologist. RESULTS: US-FNA had a diagnostic sample rate of 92.2 % (centre 1: 95.9 %; centre 2: 87.2 %). US-FNA repetition after non-diagnostic samples provided a diagnosis in 86.3 % of cases. Sensitivity, specificity, positive and negative predictive values, and accuracy were 98.7 %, 100 %, 100 %, 75.5 %, and 98.7 %, respectively. The complication rate was 0.8 %. CONCLUSIONS: Percutaneous US-FNA is a sensitive, accurate and safe method for the invasive diagnosis of solid pancreatic neoplasms. The use of aspiration needles and the on-site presence of a cytopathologist may lead to a high rate of diagnostic samples, thus reducing the need for US-FNA repetition. KEY POINTS: • Percutaneous ultrasound-guided fine-needle aspiration of pancreatic neoplasms is sensitive and accurate. • The short-term complication rate of percutaneous ultrasound-guided fine-needle aspiration is low. • Technical aspects may influence the rate of diagnostic samples.

2 Article Histologic retrieval rate of a newly designed side-bevelled 20G needle for EUS-guided tissue acquisition of solid pancreatic lesions. 2019

Armellini, Elia / Manfrin, Erminia / Trisolini, Elena / Andorno, Silvano / Ballarè, Marco / Bernardoni, Laura / Boldorini, Renzo Luciano / Gabbrielli, Armando / Frulloni, Luca / Larghi, Alberto / Occhipinti, Pietro / Scarpa, Aldo / Crinò, Stefano Francesco. ·Department of Gastroenterology, 'Maggiore della Carità' Hospital, Novara, Italy. · Department of Pathology and Diagnostics, G.B. Rossi University Hospital, Verona, Italy. · Department of Health Sciences, School of Medicine, University of Eastern Piedmont 'Amedeo Avogadro', Novara, Italy. · Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy. · Department of Pathology, 'Maggiore della Carità' Hospital, Novara, Italy. · Digestive Endoscopy Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy. · ARC-Net Research Centre, G.B. Rossi University Hospital, Verona, Italy. ·United European Gastroenterol J · Pubmed #30788121.

ABSTRACT: Background: Innovative approaches to improve diagnostic yield of endoscopic ultrasound-guided tissue acquisition (EUS-TA) have focused on needle design with development of fine-needle biopsy (FNB) needles with microcore-acquisition technology. Recently, a 20-gauge (20G) antegrade-cutting-side-bevelled biopsy needle (ProCore®) was developed for EUS-TA, but data about its diagnostic performance and histological capability are scant. Objectives: We assessed the diagnostic performance and histologic retrieval rate of a new 20G antegrade-cutting-side-bevelled biopsy needle compared with a 22G reverse-side-bevelled needle for EUS sampling of solid pancreatic lesions. Patients and methods: A retrospective analysis of 238 consecutively collected patients who underwent EUS-TA using a 20G or a 22G ProCore® needle, without rapid on-site evaluation (ROSE), was conducted at two centres.Sensitivity, specificity, positive predictive value and negative predictive value were calculated. Histologic tissue retrieval was evaluated applying a scoring system for each case. Results: Sensitivity and specificity were estimated as 98.4-100% in the 20G-, and 94.9-100% in the 22G-needle groups, respectively ( Conclusions: Both side-bevelled FNB needles achieved a high diagnostic sensitivity. The 20G-side-bevelled needle obtained a significantly higher microcore retrieval rate.

3 Article Touch imprint cytology on endoscopic ultrasound fine-needle biopsy provides comparable sample quality and diagnostic yield to standard endoscopic ultrasound fine-needle aspiration specimens in the evaluation of solid pancreatic lesions. 2019

Crinò, Stefano Francesco / Larghi, Alberto / Bernardoni, Laura / Parisi, Alice / Frulloni, Luca / Gabbrielli, Armando / Parcesepe, Pietro / Scarpa, Aldo / Manfrin, Erminia. ·Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy. · Digestive Endoscopy Unit, IRCCS, Fondazione Policlinico Universitario A. Gemelli, Roma, Italy. · Department of Diagnostics and Public Health, G.B. Rossi University Hospital, Verona, Italy. · ARC-Net Research Centre, G.B. Rossi University Hospital, Verona, Italy. ·Cytopathology · Pubmed #30484917.

ABSTRACT: OBJECTIVES: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the gold standard for the diagnosis of solid pancreatic lesions (SPLs). Cytological samples can also be obtained using touch imprint cytology (TIC) on EUS fine-needle biopsy (FNB) specimens. We aimed to compare sample quality and diagnostic yield of EUS-FNA-standard cytology (EUS-FNA-SC) to that of EUS-FNB-TIC in a series of patients with SPLs. METHODS: Thirty-two consecutive patients referred for EUS-tissue acquisition of SPLs who underwent rapid on-site evaluation of both EUS-FNA-SC and paired EUS-FNB-TIC during the same endoscopic session were retrospectively identified. Sample quality (evaluated in terms of blood contamination, presence of clots, tissue casts, cellularity, and necrosis) and diagnostic yield were compared between the techniques. RESULTS: The mean number of passes to reach diagnosis at rapid on-site evaluation was similar between EUS-FNA-SC and EUS-FNB-TIC (1.09 ± 0.3 vs 1.13 ± 0.34, P = .711). EUS-FNA-SC scores of sample quality were comparable to those of EUS-FNB-TIC (blood contamination, 2.47 ± 1.11 vs 2.25 ± 1.14, P = .109; clots, 1.25 ± 0.76 vs 1.19 ± 0.69, P = .624; tissue casts, 3.56 ± 0.88 vs 3.59 ± 1.09, P = .872; cellularity, 2.84 ± 1.11 vs 3.09 ± 1.09, P = .244; necrosis, 2.25 ± 1.08 vs 2.53 ± 1.02 P = .059; total score, 12.38 ± 2.88 vs 17.66 ± 2.38, P = .536). Adequacy, sensitivity and diagnostic accuracy of the two sampling techniques were equal (93.7%, 90.6% and 90.6%, respectively). CONCLUSIONS: EUS-FNB-TIC provides comparable samples to those of EUS-FNA-SC and combines the benefits of cytology and histology for the evaluation of SPLs by employing a single needle during the same endoscopic procedure.

4 Article Patterns of Recurrence after Resection for Pancreatic Neuroendocrine Tumors: Who, When, and Where? 2019

Marchegiani, Giovanni / Landoni, Luca / Andrianello, Stefano / Masini, Gaia / Cingarlini, Sara / D'Onofrio, Mirko / De Robertis, Riccardo / Davì, Mariavittoria / Capelli, Paola / Manfrin, Erminia / Amodio, Antonio / Paiella, Salvatore / Malleo, Giuseppe / Damoli, Isacco / Miotto, Marco / Bianchi, Beatrice / Nessi, Chiara / Vivani, Elena / Scarpa, Aldo / Salvia, Roberto / Bassi, Claudio. ·Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy. · Department of Oncology, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy. · Department of Radiology, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy. · Department of Medicine, University of Verona Hospital Trust, Verona, Italy. · Pathology, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy. · Department of Gastroenterology, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy. · Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy, roberto.salvia@univr.it. ·Neuroendocrinology · Pubmed #30481765.

ABSTRACT: BACKGROUND/AIMS: Pancreatic neuroendocrine tumors (pan-NENs) represent an increasingly common indication for pancreatic resection, but there are few data regarding possible recurrence after surgery. The aim of the study was to describe the frequency, timing, and patterns of recurrence after resection for pan-NENs with consequent implications for postoperative follow-up. METHODS: We performed a retrospective analysis of pan-NENs resected between 1990 and 2015 at The Pancreas Institute, University of Verona Hospital Trust. Predictors of recurrence were assessed. Survival analysis was conducted using the Kaplan-Meier and conditional survival (CS) methods. RESULTS: The cohort consisted of 487 patients with a median follow-up of 71 months. Recurrence developed in 12.3%: 54 (11.1%) liver metastases, 11 (2.3%) local recurrence, 10 (2.1%) nodal recurrence, and 8 (1.6%) metastases in other organs. Thirty-one (6.4%) died due to disease recurrence. Size > 21 mm, G3 grade, nodal metastasis, and vascular infiltration were independent predictors of overall recurrence. Recurrence occurred either during the first year of follow-up (n = 9), or after 10 years (n = 4). CS analysis revealed that nonfunctioning G1 pan-NEN ≤20 mm without nodal metastasis or vascular invasion had a negligible risk of developing recurrence. In the present series, after 5 years of follow-up without developing recurrence, tumor recurrence occurred only in the form of liver metastases. CONCLUSIONS: Recurrence of pan-NENs is rare and is predicted by tumor size, nodal metastasis, grading, and vascular invasion. Patients with G1 pan-NEN without nodal metastasis and vascular invasion may be considered cured by surgery. After 5 years without recurrence, follow-up should focus on excluding the development of liver metastases.

5 Article Endoscopic ultrasound-through-the-needle biopsy in pancreatic cystic lesions: A multicenter study. 2018

Barresi, Luca / Crinò, Stefano F / Fabbri, Carlo / Attili, Fabia / Poley, Jan W / Carrara, Silvia / Tarantino, Ilaria / Bernardoni, Laura / Giovanelli, Silvia / Di Leo, Milena / Manfrin, Erminia / Tacelli, Matteo / Bruno, Marco J / Traina, Mario / Larghi, Alberto. ·Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Highly Specialized Therapies), Palermo, Italy. · Department of Medicine, Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy. · Department of Gastroenterology and Surgical Sciences, Bellaria-Maggiore Hospital, AUSL Bologna, University of Bologna, Bologna, Italy. · Digestive Endoscopy Unit, Catholic University, Rome, Italy. · Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands. · Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Milan, Italy. · Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy. ·Dig Endosc · Pubmed #29808529.

ABSTRACT: BACKGROUND AND AIM: Tissue acquisition in pancreatic cystic lesions (PCL) is the ideal method for diagnosis and risk stratification for malignancy of these lesions. Direct sampling from the walls of PCL with different devices has shown better results than cytology from cystic fluid. We carried out a retrospective, multicenter study to evaluate the feasibility, safety, and diagnostic yield of a micro-forceps, specifically designed to be used through a 19-gauge needle after endoscopic ultrasonography (EUS)-guided puncture of PCL. METHODS: We retrospectively collected data from patients who underwent EUS-through-the-needle biopsy (EUS-TTNB) in PCL at six referral centers. RESULTS: The sampling procedure was carried out in 56 patients (mean age 57.5 ± 13.1 years, M:F 17:39), and was technically successful in all of them (100%; 95% confidence interval [CI], 94-100%). Adverse events occurred in 9/56 (16.1%; 95% CI, 8-28%) patients, with self-limited intracystic hemorrhage the most common (7/56, 12.5%; 95% CI, 5-24%). All adverse events were mild, and resolved without any specific intervention. Specimens were considered adequate for histological diagnosis in 47/56 (83.9%; 95% CI, 72-92%). In two of these patients, despite the histological adequacy, a diagnosis could not be reached. In two other cases, a specimen sufficient for a cytological diagnosis was obtained. Overall diagnostic yield by combining cytological and histological samples was 47/56 (83.9%; 95% CI, 72-92%). CONCLUSION: EUS-TTNB with micro-forceps in PCL is feasible, safe, and has a high diagnostic yield. Future prospective studies are needed to better assess the clinical impact of EUS-TTNB on the management of PCL.

6 Article Diagnostic yield of EUS-FNA of small (≤15 mm) solid pancreatic lesions using a 25-gauge needle. 2018

Crinò, Stefano Francesco / Conti Bellocchi, Maria Cristina / Bernardoni, Laura / Manfrin, Erminia / Parisi, Alice / Amodio, Antonio / De Pretis, Nicolò / Frulloni, Luca / Gabbrielli, Armando. ·Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona, G.B. Rossi University Hospital, 11 P.le L.A. Scuro 10, Verona 37134, Italy. Electronic address: stefanofrancesco.crino@ospedaleuniverona.it. · Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona, G.B. Rossi University Hospital, 11 P.le L.A. Scuro 10, Verona 37134, Italy. · Department of Pathology, University of Verona, G.B. Rossi University Hospital, 11 P.le L.A. Scuro 10, Verona 37134, Italy. ·Hepatobiliary Pancreat Dis Int · Pubmed #29428108.

ABSTRACT: BACKGROUND: Early detection of small solid pancreatic lesions is increasingly common. To date, few and contradictory data have been published about the relationship between lesion size and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) diagnostic yield. The aim of this study was to assess the relation between the size of solid pancreatic lesions and the diagnostic yield of EUS-FNA using a 25-gauge needle in a center without available rapid on-site evaluation. METHODS: In the retrospective cohort study, we selected patients who underwent EUS-FNA for solid pancreatic lesions with a 25-gauge needle from October 2014 to October 2015. Patients were divided into three groups (≤15 mm, 16-25 mm and >25 mm), and the outcomes were compared. RESULTS: We analyzed 163 patients. Overall adequacy, sensitivity, specificity and accuracy were 85.2%, 81.8%, 93.7%, and 80.4%, respectively. When stratified by size, the sensitivity and accuracy correlated with size (P = 0.016 and P = 0.042, respectively). Multivariate analysis showed that lesion size was the only independent factor (P = 0.019, OR = 4.76) affecting accuracy. The role of size as an independent factor affecting accuracy was confirmed in a separate multivariate analysis, where size was included in the model as a covariate (P = 0.018, OR = 1.08). CONCLUSION: Our study demonstrates that, in the absence of rapid on-site evaluation, mass size affects the accuracy of EUS-FNA of solid pancreatic lesions.