Diagnostic efficacy of cell block immunohistochemistry, smear cytology, and liquid-based cytology in endoscopic ultrasound-guided fine-needle aspiration of pancreatic lesions: a single-institution experience

• Published in: PloS one Vol. 9; no. 9; p. e108762
• Main Authors: Qin, Shan-Yu, Zhou, You, Li, Ping, Jiang, Hai-Xing
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 26.09.2014; Public Library of Science (PLoS)
• Subjects: Accuracy; Adult; Aged; Catheters; Cellular biology; Comparative analysis; Cytodiagnosis - methods; Cytology; Diagnostic systems; Effectiveness; Endoscopes; Endoscopic ultrasonography; Endoscopic Ultrasound-Guided Fine Needle Aspiration - methods; Endoscopy; Family medical history; Female; Gastroenterology; Humans; Immunohistochemistry; Immunohistochemistry - methods; Laboratories; Lesions; Male; Medical diagnosis; Medicine and Health Sciences; Methods; Middle Aged; Pancreas; Pancreas - pathology; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - metabolism; Pancreatic Neoplasms - pathology; Patients; Predictive Value of Tests; Sensitivity and Specificity; Smear; Studies; Surgery; Tumors; Ultrasonic imaging; Ultrasound; Young Adult; United States > US; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0108762

The diagnostic efficiency of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytology varies widely depending on the treatment method of the specimens. The present study aimed to evaluate the diagnostic efficacy of cell block (CB) immunohistochemistry, smear cytology (SC), and liquid-based cytology (LBC) in patients with pancreatic lesions without consulting an on-site cytopathologist. This study prospectively enrolled 72 patients with pancreatic lesions. The EUS-FNA specimens were examined by SC, LBC, and CB immunohistochemistry. The diagnostic efficacy of the 3 methods was then compared. Patients' final diagnosis was confirmed by surgical resection specimens, diagnostic imaging, and clinical follow-up. Our results included 60 malignant and 12 benign pancreatic lesions. The diagnostic sensitivity (90%), negative predictive value (66.7%), and accuracy (91.7%) of CB immunohistochemistry were significantly higher than those of SC (70.0%, 30.0%, and 75.0%, respectively) and LBC (73.3%, 31.6%, and 77.8%, respectively) (all P<0.05). The combination of CB and SC, or CB and LBC, did not significantly increase the efficacy compared to CB immunohistochemistry alone. Our findings suggest that in the absence of an on-site cytopathologist, CB immunohistochemistry on EUS-FNA specimens offers a higher diagnostic efficacy in patients with pancreatic lesions than does SC and LBC.