Impact of endoscopic ultrasound-guided fine needle biopsy for diagnosis of pancreatic masses

• Published in: World journal of gastroenterology : WJG Vol. 13; no. 2; pp. 289 - 293
• Main Author: Julio Iglesias-Garcia Enrique Dominguez-Munoz Antonio Lozano-Leon Ihab Abdulkader Jose Larino-Noia Jose Antunez Jeronimo Forteza
• Format: Journal Article
• Language: English
• Published: United States Gastroenterology Department, University Hospital, Santiago de Compostela, Spain 14.01.2007; Foundation for Research in Digestive Diseases, Santiago de Compostela, Spain%Foundation for Research in Digestive Diseases, Santiago de Compostela, Spain%Pathology Department, University Hospital, Santiago de Compostela, Spain; Baishideng Publishing Group Co., Limited
• Subjects: Adult; Aged; Aged, 80 and over; Biopsy, Fine-Needle - methods; Endoscopy - methods; Endosonography - methods; Female; Humans; Male; Middle Aged; Pancreas - pathology; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - pathology; Rapid Communication; 活组织检查; 组织病理学; 胰腺炎; 诊断方法; Biopsy; Pancreatic cancer; Endoscopic ultrasound; Cytology; Fine needle aspiration
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v13.i2.289

AIM： To evaluate the diagnostic accuracy of histological evaluation of pancreatic tissue samples obtained by a modified method for recovering and processing the endoscopic ultrasound （EUS）-guided fine needle aspiration （FNA） material in the differential diagnosis of pancreatic solid masses. METHODS： Sixty-two consecutive patients with pancreatic masses were prospectively studied. EUS was performed by the linear scanning Pentax FG-38UX echoendoscope. Three FNAs （22G needle） were carried out during each procedure. The materials obtained with first and second punctures were processed for cytological study. Haterials of the third puncture were recovered into 10% formol solution by careful injection of saline solution through the needle, and processed for histological study. RESULTS： Length of the core specimen obtained for histological analysis was 6.5±5.3 mm （range 1-22 mm）. Cytological and histological samples were considered as adequate in 51 （82.3%） and 52 cases （83.9%）, respectively. Overall sensitivity of both pancreatic cytology and histology for diagnosis of malignancy was 68.4%. Conbary to cytology, histology was able to diagnose tumours other than adenocarcinomas, and all cases of inflammatory masses. Combination of cytology and histology allowed obtaining an adequate sample in 56 cases （90.3%）, with a global sensitivity of 84.21%, specificity of 100% and an overall accuracy of 90.32%. The complication rate was 1.6%.CONCLUSION： Adequate pancreatic core specimens for histological examination can be obtained by EUS-guided FNA. This technique is mainly useful for the diagnosis of different types of pancreatic tumours and evaluation of benign diseases.