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Effect of pancreatic juice cytology and/or endoscopic ultrasound‐guided fine‐needle aspiration biopsy for pancreatic tumor
Author(s) -
Matsumoto Kazuya,
Takeda Yohei,
Harada Kenichi,
Horie Yasushi,
Yashima Kazuo,
Murawaki Yoshikazu
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12332
Subject(s) - medicine , fine needle aspiration , endoscopic ultrasound , radiology , biopsy , pancreatic cancer , malignancy , cytology , predictive value , carcinoma , pancreas , gastroenterology , cancer , pathology
Background and Aim Endoscopic ultrasound‐guided fine‐needle aspiration biopsy ( EUS‐FNA ) can now provide a cytopathological diagnosis of pancreatic malignancy with higher success rates. However, EUS‐FNA cannot be carried out for lesions of minimally invasive carcinoma because they cannot be detected by endoscopic ultrasonography, and in cases of intraductal papillary mucinous carcinoma ( IPMC ) because of the potential for needle tract seeding. A recent study has shown that pancreatic juice cytology ( PJC ) is useful for diagnosing pancreatic cancer. This study's aim was to evaluate whether PJC strengthens the diagnostic power of EUS‐FNA for pancreatic masses. Methods A total of 161 patients, who were suspected to have a pancreatic mass on conventional ultrasound and/or computed tomography, was enrolled. Results EUS‐FNA was carried out in 121 cases, and PJC was performed in 83 cases. An adequate specimen was obtained for EUS‐FNA in 96.0% and for PJC in 98.9%. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 86.0%, 100%, 100%, 70.5%, and 89.5% for EUS‐FNA , and 71.4%, 100%, 100%, 84.4%, and 88.8% for PJC , respectively. EUS‐FNA and/or PJC for the diagnosis of pancreatic tumor had a sensitivity of 92.5%, specificity of 100%, positive predictive value of 100%, negative predictive value of 91.7%, and accuracy of 95.9%. The diagnostic accuracy of EUS‐FNA and/or PJC was significantly higher than that of EUS‐FNA alone or PJC alone. Conclusion PJC improved the diagnostic utility of EUS‐FNA for pancreatic tumor.