Endoscopic ultrasound-guided pancreatic fine-needle aspiration: potential pitfalls in one institution's experience of 1212 procedures.

摘要: BACKGROUND Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has emerged as the diagnostic modality of choice for mass lesions in pancreas. The objective current study was to determine accuracy and pitfalls EUS-FNA diagnosis pancreatic cases that involved follow-up surgical resection. METHODS Cases performed from 2007 mid-2012 which subsequent resection were retrieved department's database. cytologic assessed using histological gold standard. sensitivity, specificity, positive predictive value, negative value calculated. “Neoplastic,” “suspicious,” “malignant” classified a diagnosis. In one calculation method, “atypical” also included whereas another it not considered be cytological result. with cytologic-histological discrepancy reviewed identify sources errors. RESULTS A total 1212 1104 patients (518 women 586 men; age range, 18-94 years [average age, 63.5 years]) identified. Cytologic diagnoses 52 unsatisfactory, 224 benign, 129 atypical, 140 neoplasm, 35 suspicious, 632 malignant diagnoses. Of these cases, 397 had information available. 83.2%, 85.9%, 95.9%, 56.1%, respectively, atypical excluded analysis. When diagnosis, 86.7%, 67.9%, 90.7%, 58.5%, 73.7%, 87.7%, 95.6%, 48.0%, when major difficulty cytology differentiate mucinous neoplasms contaminants gastric mucosa. Other differentiating neoplasm extensive intraepithelial neoplasia, endocrine tumor nesidioblastosis versus acinar cell carcinoma or intrapancreatic spleen. CONCLUSIONS EUS-FNA is valuable tool lesions, especially solid tumors. Cytologic-radiological correlation essential mucosa, because former usually are found have characteristic features on imaging. Pathologists should aware may significantly change clinical management patients. Cancer (Cancer Cytopathol) 2015;123:98–107. © 2014 American Society.